Virtual Dietitian LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

VIRTUAL DIETITIAN LLC

Practice address

971 Hilltop Dr
Weatherford, TX 76086-5845

Phone

(817) 602-5909

NPI assigned

Jun 30, 2022

Organization subpart

No

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

Authorized official

Name

Stacey Wood, RDN

Title

Dietitian

Phone

(817) 381-8679

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1104558733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 856",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760860856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 HILLTOP DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865845",
            "telephone_number": "817-602-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRTUAL DIETITIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "817-381-8679",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.