Active NPI
Mindy Diller
- Metabolic Nutrition Registered Dietitian
- Lubbock, TX
National Provider Identifier
1073931200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- License
- DT83120
- Practice address
- 2431 S Loop 289
Lubbock, TX 79423-1519 - Phone
- (806) 771-7661
- NPI assigned
- Apr 4, 2014
- Last updated
- Oct 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | DT83120 | TX | Primary |
Addresses
Primary practice location
2431 S Loop 289
Lubbock, TX 79423-1519
Mailing address
2431 S Loop 289
Lubbock, TX 79423-1519
Phone (806) 771-7661
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 337183301 | Medicaid | TX | |
| 8EG102 | Other | TX | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414627200000",
"number": "1073931200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2431 S LOOP 289",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794231519",
"telephone_number": "806-771-7661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2431 S LOOP 289",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794231519",
"telephone_number": "806-771-7661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLER",
"first_name": "MINDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-04",
"last_updated": "2014-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "TX",
"license": "DT83120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "337183301",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8EG102",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.