Active NPI
Traci Quebedeaux, MS, RD, LDN
- Registered Dietitian
- Lafayette, LA
National Provider Identifier
1134475254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1376
- Practice address
- 201 W. Willow St BLDG a
Lafayette, LA 70501 - Phone
- (337) 262-5616
- Fax
- (337) 262-4976
- NPI assigned
- Jul 26, 2012
- Sex
- Female
- 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 | 1376 | LA | Primary |
Addresses
Primary practice location
201 W. Willow St BLDG a
Lafayette, LA 70501
Mailing address
107 Keeneland LN
Lafayette, LA 70503-6213
Phone (337) 262-5616
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1376 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343260800000",
"number": "1134475254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 KEENELAND LN",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705036213",
"telephone_number": "337-262-5616",
"fax_number": "337-262-4976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 W. WILLOW ST BLDG A",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70501",
"telephone_number": "337-262-5616",
"fax_number": "337-262-4976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEBEDEAUX",
"first_name": "TRACI",
"credential": "MS, RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-26",
"last_updated": "2012-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "1376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.