Active NPI
Dianne Marie Denotter, RD, CSG, LD
- Gerontological Nutrition Registered Dietitian
- Portland, OR
National Provider Identifier
1215470331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontological Nutrition Registered Dietitian
- Practice address
- 13007 NE Glisan St
Portland, OR 97230-2545 - Phone
- (503) 215-3484
- NPI assigned
- Nov 21, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD-D-10176117 | OR | |
| Gerontological Nutrition Registered Dietitian | 133VN1101X | Primary |
Addresses
Primary practice location
13007 NE Glisan St
Portland, OR 97230-2545
Mailing address
13007 NE Glisan St
Portland, OR 97230-2545
Phone (503) 215-3484
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 |
|---|---|---|---|
| LD-D-10176117 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571961600000",
"number": "1215470331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13007 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972302545",
"telephone_number": "503-215-3484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13007 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972302545",
"telephone_number": "503-215-3484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENOTTER",
"first_name": "DIANNE",
"middle_name": "MARIE",
"credential": "RD, CSG, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-21",
"last_updated": "2019-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "LD-D-10176117",
"primary": false
},
{
"code": "133VN1101X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Gerontological",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.