Individual provider Active NPI

Flower Star

  • Registered Dietitian
  • Othello, WA
National Provider Identifier
1124646260
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI61081752 Issued in WA
Practice address
1515 E Columbia St
Othello, WA 99344-1846
Phone
(509) 488-5256
NPI assigned
Jul 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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 DI61081752 WA Primary

Addresses

Primary practice location

1515 E Columbia St
Othello, WA 99344-1846

Mailing address

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210128002249 WA Practitioner - Registered Dietitian Or Nutrition Professional 8729492962 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Basin Health Association CurrentSince Dec 7, 2020 Accepting new patients
Columbia Basin Health Association CurrentSince Dec 7, 2020 Accepting new patients
Columbia Basin Health Association Current Accepting new patients
Columbia Basin Health Association Past Accepting new patients

Locations

601 Government Rd
Mattawa, WA 99349
Phone 5094885256 ext. 8512

1515 E Columbia St
Othello, WA 99344
Phone (509) 488-5250

7405 Three Rivers Dr
Pasco, WA 99301
Phone 5094885256 ext. 8512

Organizations & group practices 4

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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1124646260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAR",
        "first_name": "FLOWER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61081752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Othello, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.