Tanya Ortiz, LICENSED DIETITIAN

Primary specialty

NutritionistTaxonomy code 133N00000X

License

2004008861 Issued in MO

Practice address

2200 Lemp
St. Louis, MO 63104

Phone

(314) 814-8556

Fax

(314) 814-8542

NPI assigned

May 8, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tanya Lutz Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Affinia Healthcare

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
  • NPI 1740067719
  NPD (past)

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1174757868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 LEMP AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042700",
            "telephone_number": "314-814-8556",
            "fax_number": "314-814-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 LEMP",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63104",
            "telephone_number": "314-814-8556",
            "fax_number": "314-814-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "TANYA",
        "credential": "LICENSED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MO",
            "license": "2004008861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "LUTZ",
            "credential": "LICENSED DIETITIAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Orthotic and Prosthetic Lab, Inc.
• Amadu Padama Ortillo, MD
• Irma I Ortiz-Arroyo, MD
• Christian Gage Ortiz, AA-S
• Gina M Ortiz
• Vivian Ortiz, MD
• Julie Ortman
• Madeleine R. Ortman, RN, PCNS, CPNP
• Shannon Ortman, PT
• Amanda Judith Ortmann, AUD

• Nutritionist in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Nutritionist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.