Individual provider Active NPI

Stephanie Macneill, RD

  • Registered Dietitian
  • Clovis, CA
National Provider Identifier
1124769906
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
3174 Laverne Ave
Clovis, CA 93611-5283
Phone
(562) 896-2790
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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 Primary

Addresses

Primary practice location

3174 Laverne Ave
Clovis, CA 93611-5283

Mailing address

3174 Laverne Ave
Clovis, CA 93611-5283
Phone (562) 896-2790

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226003941 CA Practitioner - Registered Dietitian Or Nutrition Professional 3476998758 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lindsay Dietetic Services Incorporated Dietitian, Registered CurrentSince Jan 14, 2024 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Locations

755 N Peach Ave
Ste A1
Clovis, CA 93611
Phone (559) 321-7836

5614 N Fresno St
Ste 118
Fresno, CA 93710
Phone (559) 281-5748

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1124769906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3174 LAVERNE AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936115283",
            "telephone_number": "562-896-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3174 LAVERNE AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936115283",
            "telephone_number": "562-896-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACNEILL",
        "first_name": "STEPHANIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.