Individual provider Active NPI

Heidi Dawn Dyer-Raley, RD

  • Registered Dietitian
  • Northport, AL
National Provider Identifier
1194912147
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1853 Issued in AL
Practice address
505 Energy Center Bloulevard
Suite 602
Northport, AL 35473
Phone
(205) 752-0101
Fax
(205) 752-0110
NPI assigned
Oct 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1853 AL Primary

Addresses

Primary practice location

505 Energy Center Bloulevard
Suite 602
Northport, AL 35473

Mailing address

11488 County Road 27
Reform, AL 35481-3543

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1853ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
West Alabama Nutritional Consultants, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1194912147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11488 COUNTY ROAD 27",
            "city": "REFORM",
            "state": "AL",
            "postal_code": "354813543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ENERGY CENTER BLOULEVARD",
            "address_2": "SUITE 602",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "35473",
            "telephone_number": "205-752-0101",
            "fax_number": "205-752-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER-RALEY",
        "first_name": "HEIDI",
        "middle_name": "DAWN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AL",
            "license": "1853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.