Alyssa Kay Stacey, R.D., C.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

5986583-4901 Issued in UT

Practice address

1160 E 3900 S # G-100
Salt Lake City, UT 84124-1202

Phone

(801) 268-7479

Fax

(801) 268-7622

NPI assigned

Sep 17, 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

• Alyssa Kay Anderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1225361504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 S 1300 W STE B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841197233",
            "telephone_number": "385-388-8024",
            "fax_number": "385-770-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S # G-100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241202",
            "telephone_number": "801-268-7479",
            "fax_number": "801-268-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "ALYSSA",
        "middle_name": "KAY",
        "credential": "R.D., C.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "5986583-4901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "ANDERSON",
            "middle_name": "KAY",
            "credential": "RD, CD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• St. Marks Transitional Care Center
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• Kelly Ann Stace, DNP, APRN, NNP-BC
• Stacey Bank MD PC
• Stacey M. Francone, LCSW Inc.
• Stacie Sears LLC (Black Dog Counseling LLC)
• Samantha Lee Stacks, NP
• Stacy R Smith MD PC
• Ryan Stadheim
• Bonnie Jean Stafford-Litton

• Registered Dietitian in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Registered Dietitian in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.

Verify at the official NPI Registry.