Individual provider Active NPI

Joan C Connor, MS,RD,LDN

  • Registered Dietitian
  • Germantown, TN
National Provider Identifier
1073633236
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LDN0000001172 Issued in TN
Practice address
9933 S Houston Way
Germantown, TN 38139-6942
Phone
(901) 853-6705
Fax
(901) 853-0463
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LDN0000001172 TN Primary

Addresses

Primary practice location

9933 S Houston Way
Germantown, TN 38139-6942

Mailing address

9933 S Houston Way
Germantown, TN 38139-6942
Phone (901) 853-6705

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LDN0000001172TNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073633236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 S HOUSTON WAY",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381396942",
            "telephone_number": "901-853-6705",
            "fax_number": "901-853-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 S HOUSTON WAY",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381396942",
            "telephone_number": "901-853-6705",
            "fax_number": "901-853-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "JOAN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MS,RD,LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "LDN0000001172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.