Individual provider Active NPI

Adam Keith Lax, RD/LDN

  • Registered Dietitian
  • West Palm Beach, FL
National Provider Identifier
1104071539
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND2293 Issued in FL
Practice address
1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2302
Phone
(954) 292-5625
Fax
(772) 334-8781
NPI assigned
Nov 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND2293 FL Primary
Registered Dietetic TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 136A00000X ND2293 FL

Addresses

Primary practice location

1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2302

Mailing address

450 Mulberry Grove Rd
Royal Palm Beach, FL 33411-4531
Phone (954) 292-5625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100524000235 FL Practitioner - Registered Dietitian Or Nutrition Professional 8921137308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2302
Phone (954) 292-5625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND2293FLMDRegistered Dietetic Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Rd4U Inc Dietetic Technician, Registered CurrentSince Mar 26, 2010 Accepting new patients

Locations

1552 Palm Beach Lakes Blvd
West Palm Beach, FL 33401
Phone (561) 659-7411

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1104071539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MULBERRY GROVE RD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334114531",
            "telephone_number": "954-292-5625",
            "fax_number": "772-334-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012302",
            "telephone_number": "954-292-5625",
            "fax_number": "772-334-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAX",
        "first_name": "ADAM",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "RD/LDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-26",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND2293",
            "primary": true
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietetic Technician, Registered",
            "state": "FL",
            "license": "ND2293",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.