Active NPI
Brian Scott Hakes, DIETICIAN
- Registered Dietitian
- Lebanon, OR
National Provider Identifier
1104944057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 10158338
- Practice address
- 32675 Merrill LN
Lebanon, OR 97355-8817 - Phone
- (541) 409-6375
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 10158338 | OR | Primary |
Addresses
Primary practice location
32675 Merrill LN
Lebanon, OR 97355-8817
Mailing address
32675 Merrill LN
Lebanon, OR 97355-8817
Phone (541) 409-6375
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417737600000",
"number": "1104944057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32675 MERRILL LN",
"city": "LEBANON",
"state": "OR",
"postal_code": "973558817",
"telephone_number": "541-409-6375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32675 MERRILL LN",
"city": "LEBANON",
"state": "OR",
"postal_code": "973558817",
"telephone_number": "541-409-6375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAKES",
"first_name": "BRIAN",
"middle_name": "SCOTT",
"credential": "DIETICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2014-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "10158338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.