Active NPI
Cierra Lazana Mathis, RDN, LDN, M.ED.
- Registered Dietitian
- Tallahassee, FL
National Provider Identifier
1164011763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 2633 Centennial Blvd Ste 100
Tallahassee, FL 32308-0606 - Phone
- (850) 431-5404
- NPI assigned
- Jan 18, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | |||
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
2633 Centennial Blvd Ste 100
Tallahassee, FL 32308-0606
Mailing address
121 Tennel Rd
Midway, FL 32343-2607
Phone (850) 459-1025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tallahassee Memorial Healthcare Inc | Multi-Specialty | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Tallahassee, FL
- NPI 1437177664
-
- Rural Health Clinic/Center
- Crawfordville, FL
- NPI 1285683045
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610928000000",
"number": "1164011763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 TENNEL RD",
"city": "MIDWAY",
"state": "FL",
"postal_code": "323432607",
"telephone_number": "850-459-1025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2633 CENTENNIAL BLVD STE 100",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323080606",
"telephone_number": "850-431-5404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "CIERRA",
"middle_name": "LAZANA",
"credential": "RDN, LDN, M.ED.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-18",
"last_updated": "2021-01-18",
"certification_date": "2021-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.