Active NPI
Ladd Harris, R.D.
- Registered Dietitian
- Gulf Breeze, FL
National Provider Identifier
1134487648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L003966
- Practice address
- 1020 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4838 - Phone
- (850) 916-8650
- NPI assigned
- May 3, 2012
- 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 | L003966 | NC | Primary |
Addresses
Primary practice location
1020 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4838
Mailing address
486 E 9270 S
Sandy, UT 84070-6240
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L003966 | NC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1134487648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "486 E 9270 S",
"city": "SANDY",
"state": "UT",
"postal_code": "840706240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 GULF BREEZE PKWY",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325614838",
"telephone_number": "850-916-8650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "LADD",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-03",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L003966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.