Stephanie Kathryn Lodge, M.P.H.,R.D., L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2252 Issued in MN

Practice address

Veterans Administration Medical Center
One Veterans Drive
Minneapolis, MN 55417

Phone

(612) 725-2000

NPI assigned

Oct 26, 2006

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

• Miss Stephanie Kathryn Ivanca Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235214172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MINNEAPOLIS AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558032017",
            "telephone_number": "218-728-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VETERANS ADMINISTRATION MEDICAL CENTER",
            "address_2": "ONE VETERANS DRIVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55417",
            "telephone_number": "612-725-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODGE",
        "first_name": "STEPHANIE",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "M.P.H.,R.D., L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "IVANCA",
            "middle_name": "KATHRYN",
            "prefix": "MISS",
            "credential": "R.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Bolin Lockner, DPM
• Tracy Lockrem
• Brian Geoffrey Lockwood, LICSW
• Drew Lodermeier
• Carly Leah Lodewyks
• Mohammed S Lodhi Khan, PHD
• Omair Ul Haq Lodhi, M.D
• Kelsey Loeffler
• Robert J Loegering, DO
• Jennifer Loepfe

• Registered Dietitian in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.