Active NPI
Rachel Ann David, MPH, RDN, LD
- Oncology Nutrition Registered Dietitian
- West Burlington, IA
National Provider Identifier
1255913208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oncology Nutrition Registered Dietitian
- License
- 125602
- Practice address
- 1225 S Gear Ave
West Burlington, IA 52655-1691 - Phone
- (319) 768-3907
- NPI assigned
- Apr 28, 2021
- Last updated
- Jul 2, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2016030006 | MO | |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 2016030006 | MO | |
| Oncology Nutrition Registered Dietitian | 133VN1301X | 125602 | IA | Primary |
Addresses
Primary practice location
1225 S Gear Ave
West Burlington, IA 52655-1691
Mailing address
1225 S Gear Ave Ste 152
West Burlington, IA 52655-1686
Phone (816) 387-1077
Other practice location 1
1 Childrens Pl
Saint Louis, MO 63110-1081
Phone (314) 454-4249
Other names 1
- Rachel Ann Pankau
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 |
|---|---|---|---|
| 2016030006 | MO | MD | Registered Dietitian |
| 125602 | IA | MD | Oncology Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1255913208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 S GEAR AVE STE 152",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551686",
"telephone_number": "816-387-1077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 S GEAR AVE",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551691",
"telephone_number": "319-768-3907"
}
],
"practiceLocations": [
{
"address_1": "1 Childrens Pl",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101081",
"country_code": "US",
"telephone_number": "314-454-4249",
"fax_number": "314-454-2557",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVID",
"first_name": "RACHEL",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "MPH, RDN, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-28",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2016030006",
"primary": false
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "MO",
"license": "2016030006",
"primary": false
},
{
"code": "133VN1301X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Oncology",
"state": "IA",
"license": "125602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RACHEL",
"last_name": "PANKAU",
"middle_name": "ANN",
"credential": "MPH, RDN, LD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in West Burlington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.