Active NPI
Raya Jayne Beerbower, RDN
- Registered Dietitian
- Fort Wayne, IN
National Provider Identifier
1225768898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37003516A
- Practice address
- 1234 E Dupont Rd Ste 1
Fort Wayne, IN 46825-1545 - Phone
- (260) 425-6390
- NPI assigned
- Jun 15, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 37003516A | IN | Primary |
Addresses
Primary practice location
1234 E Dupont Rd Ste 1
Fort Wayne, IN 46825-1545
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220819000775 | IN | Practitioner - Registered Dietitian Or Nutrition Professional | 3779966080 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37003516A | IN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Health System Inc | Dietitian, Registered | Current | Accepting new patients |
| Parkview Health System,Inc. | Current | Accepting new patients | |
| Cloud Health Medical Group of California, P.C. | Past | Accepting new patients | |
| Cloud Health Medical Group of New Jersey, P.C. | Past | Accepting new patients | |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
| Cloud Health Medical Group, P.a. | Past | Accepting new patients |
Locations
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
1234 E DuPont Rd
Ste 1
Fort Wayne, IN 46825
Phone (260) 266-6060
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Fort Wayne, IN
- NPI 1932130952
Dietitian, Registered, IN
-
- Gastroenterology Physician
- Fort Wayne, IN
- NPI 1437461449
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1194404327
-
- Internal Medicine Physician
- Union City, NJ
- NPI 1043995467
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658966400000",
"number": "1225768898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1234 E DUPONT RD STE 1",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251545",
"telephone_number": "260-425-6390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEERBOWER",
"first_name": "RAYA",
"middle_name": "JAYNE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-15",
"last_updated": "2022-07-28",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37003516A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.