Oklahoma Nutrition Therapy, PLLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1436 Issued in OK

Legal business name

OKLAHOMA NUTRITION THERAPY, PLLC

Practice address

3351 W Rock Creek Rd Ste 120
Norman, OK 73072-2463

Phone

(405) 314-0953

Fax

(405) 701-5950

NPI assigned

Aug 17, 2018

Organization subpart

No

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

Authorized official

Name

Lisa Gibson, RDN

Title

Owner

Phone

(405) 314-0953

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1114407202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3351 W ROCK CREEK RD STE 120",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730722463",
            "telephone_number": "405-314-0953",
            "fax_number": "405-701-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 W ROCK CREEK RD STE 120",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730722463",
            "telephone_number": "405-314-0953",
            "fax_number": "405-701-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA NUTRITION THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-314-0953",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Norman, OK
• Providers in Norman, OK by specialty
• Registered Dietitian in Oklahoma

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