Individual provider Active NPI

Deborah Michelle Zachry, MPH, RD, LDN

  • Registered Dietitian
  • Longwood, FL
National Provider Identifier
1053935668
Registry record updated May 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND3633 Issued in FL
Practice address
118 Beaufort Dr
Longwood, FL 32779-5701
Phone
(407) 491-2614
NPI assigned
May 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND3633 FL Primary

Addresses

Primary practice location

118 Beaufort Dr
Longwood, FL 32779-5701

Mailing address

118 Beaufort Dr
Longwood, FL 32779-5701
Phone (407) 491-2614

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Longwood Direct
CONNECT URL Longwood Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811001148 FL Practitioner - Registered Dietitian Or Nutrition Professional 5092130997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nutrition Specialists Group LLCGroup PAC ID 3476978370, 2 clinicians

Practice addresses (Care Compare)

118 Beaufort Dr
Longwood, FL 32779-5701
Phone (321) 234-4045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND3633FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Specialists Group LLC Dietitian, Registered CurrentSince Jul 21, 2020 Accepting new patients

Locations

21 W Fee Ave
Ste C
Melbourne, FL 32901
Phone (321) 409-0256

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590883200000",
    "number": "1053935668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BEAUFORT DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795701",
            "telephone_number": "407-491-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BEAUFORT DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795701",
            "telephone_number": "407-491-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHRY",
        "first_name": "DEBORAH",
        "middle_name": "MICHELLE",
        "credential": "MPH, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-31",
        "last_updated": "2020-05-31",
        "certification_date": "2020-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND3633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Longwood",
            "affiliation": "N",
            "endpointDescription": "Home",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "118 Beaufort Dr",
            "city": "Longwood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327795701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Longwood",
            "affiliation": "N",
            "endpointDescription": "Home",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "118 Beaufort Dr",
            "city": "Longwood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327795701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.