Active NPI
Laura Jean Zervos, RDN
- Registered Dietitian
- Bethel Park, PA
National Provider Identifier
1063997138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN006509
- Practice address
- 5417 Enterprise Blvd
Bethel Park, PA 15102-2691 - Phone
- (412) 287-5679
- NPI assigned
- Sep 25, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | DN006509 | PA | |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | DN006509 | PA | |
| Metabolic Nutrition Registered Dietitian | 133VN1006X | DN006509 | PA | |
| Registered Dietitian | 133V00000X | DN006509 | PA | Primary |
Addresses
Primary practice location
5417 Enterprise Blvd
Bethel Park, PA 15102-2691
Mailing address
5417 Enterprise Blvd
Bethel Park, PA 15102-2691
Phone (412) 287-5679
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190122002645 | PA | Practitioner - Registered Dietitian Or Nutrition Professional | 6103163605 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN006509 | PA | MD | Pediatric Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537833600000",
"number": "1063997138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5417 ENTERPRISE BLVD",
"city": "BETHEL PARK",
"state": "PA",
"postal_code": "151022691",
"telephone_number": "412-287-5679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5417 ENTERPRISE BLVD",
"city": "BETHEL PARK",
"state": "PA",
"postal_code": "151022691",
"telephone_number": "412-287-5679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZERVOS",
"first_name": "LAURA",
"middle_name": "JEAN",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-25",
"last_updated": "2018-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "PA",
"license": "DN006509",
"primary": false
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "PA",
"license": "DN006509",
"primary": false
},
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "PA",
"license": "DN006509",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN006509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethel Park, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.