Active NPI
Tonia Henderson, RD, LD
- Registered Dietitian
- Klamath Falls, OR
National Provider Identifier
1245585546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD-D-000979
- Practice address
- 2865 Daggett Ave
Sky Lakes Nutrition Services
Klamath Falls, OR 97601-1106 - Phone
- (541) 274-3800
- Fax
- (541) 274-2731
- NPI assigned
- Jul 23, 2012
- 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 | LD-D-000979 | OR | Primary |
Addresses
Primary practice location
2865 Daggett Ave
Sky Lakes Nutrition Services
Klamath Falls, OR 97601-1106
Mailing address
2865 Daggett Ave
Sky Lakes Nutrition Services
Klamath Falls, OR 97601-1106
Phone (541) 274-3800
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-000979 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343001600000",
"number": "1245585546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2865 DAGGETT AVE",
"address_2": "SKY LAKES NUTRITION SERVICES",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976011106",
"telephone_number": "541-274-3800",
"fax_number": "541-274-2731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2865 DAGGETT AVE",
"address_2": "SKY LAKES NUTRITION SERVICES",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976011106",
"telephone_number": "541-274-3800",
"fax_number": "541-274-2731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "TONIA",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-23",
"last_updated": "2012-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "LD-D-000979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.