Active NPI
Bethany Joy Motley, RD
- Registered Dietitian
- Minnetonka, MN
National Provider Identifier
1255083671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4454
- Practice address
- 5625 Vine Hill Rd
Minnetonka, MN 55345-5038 - Phone
- (218) 213-6472
- NPI assigned
- Jan 26, 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 | 4454 | MN | Primary |
Addresses
Primary practice location
5625 Vine Hill Rd
Minnetonka, MN 55345-5038
Mailing address
5625 Vine Hill Rd
Minnetonka, MN 55345-5038
Phone (218) 213-6472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4454 | MN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bethanyrd Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
Organizations & group practices 1
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": "1643155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643155200000",
"number": "1255083671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5625 VINE HILL RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553455038",
"telephone_number": "218-213-6472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5625 VINE HILL RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553455038",
"telephone_number": "218-213-6472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTLEY",
"first_name": "BETHANY",
"middle_name": "JOY",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-26",
"last_updated": "2022-01-26",
"certification_date": "2022-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "4454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.