Individual provider Active NPI

Lori Lynne Smith, R.D.

  • Registered Dietitian
  • Wray, CO
National Provider Identifier
1104052315
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
871551 Issued in NU
Practice address
1017 W 7TH St
Wray, CO 80758-1420
Phone
(970) 332-4895
NPI assigned
Jun 2, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 871551 NU Primary

Addresses

Primary practice location

1017 W 7TH St
Wray, CO 80758-1420

Mailing address

1017 W 7TH St
Wray, CO 80758-1420
Phone (970) 332-4895

Other practice location 1

252 S 14th St
Burlington, CO 80807-2321
Phone (719) 346-7158 ext. 16

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": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104052315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W 7TH ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581420",
            "telephone_number": "970-332-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W 7TH ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581420",
            "telephone_number": "970-332-4895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "CO",
            "postal_code": "808072321",
            "country_code": "US",
            "telephone_number": "719-346-7158 x16",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LORI",
        "middle_name": "LYNNE",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "871551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wray, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.