Individual provider Active NPI

Raya Jayne Beerbower, RDN

  • Registered Dietitian
  • Fort Wayne, IN
National Provider Identifier
1225768898
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
37003516A Issued in IN
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

Updated by the provider on Jul 28, 2022

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 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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
37003516AINMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Dietitian, Registered Current Accepting new patients
Parkview Health System,Inc. CurrentSince Jul 14, 2022 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.

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.

Verify at the official NPI Registry.