Individual provider Active NPI

Hannah Victoria Tolley-Vidal, RD

  • Registered Dietitian
  • Tallahassee, FL
National Provider Identifier
1063935609
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND7591 Issued in FL
Practice address
4500 W Shannon Lakes Dr Ste 3
Tallahassee, FL 32309-2240
Phone
(850) 942-2000
Fax
(850) 942-2003
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 ND7591 FL Primary

Addresses

Primary practice location

4500 W Shannon Lakes Dr Ste 3
Tallahassee, FL 32309-2240

Mailing address

4500 W Shannon Lakes Dr Ste 3
Tallahassee, FL 32309-2240
Phone (850) 942-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND7591FLMDRegistered Dietitian

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10572/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063935609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 W SHANNON LAKES DR STE 3",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092240",
            "telephone_number": "850-942-2000",
            "fax_number": "850-942-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 W SHANNON LAKES DR STE 3",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092240",
            "telephone_number": "850-942-2000",
            "fax_number": "850-942-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEY-VIDAL",
        "first_name": "HANNAH",
        "middle_name": "VICTORIA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND7591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.