Active NPI
Carol Deal
- Registered Dietitian
- Potosi, MO
National Provider Identifier
1144644139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1001011692
- Practice address
- 300 Health Way Dr
Potosi, MO 63664-1420 - Phone
- (573) 438-5451
- Fax
- (573) 438-5460
- NPI assigned
- Feb 11, 2014
- Last updated
- Feb 11, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 1001011692 | MO | Primary |
Addresses
Primary practice location
300 Health Way Dr
Potosi, MO 63664-1420
Mailing address
300 Health Way Dr
Potosi, MO 63664-1420
Phone (573) 438-5451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2001011692 | Other | MO | LICENSED DIETITIAN |
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 |
|---|---|---|---|
| 1001011692 | MO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1144644139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 HEALTH WAY DR",
"city": "POTOSI",
"state": "MO",
"postal_code": "636641420",
"telephone_number": "573-438-5451",
"fax_number": "573-438-5460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 HEALTH WAY DR",
"city": "POTOSI",
"state": "MO",
"postal_code": "636641420",
"telephone_number": "573-438-5451",
"fax_number": "573-438-5460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAL",
"first_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-11",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "1001011692",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED DIETITIAN",
"identifier": "2001011692",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Potosi, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.