Active NPI
Joyce Elaine Outlaw, R.D. L.D. M.S.
- Registered Dietitian
- Dublin, GA
National Provider Identifier
1275625089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD001552
- Practice address
- 1826 Veterans Blvd
Dublin, GA 31021-3620 - Phone
- (478) 272-1210
- NPI assigned
- Sep 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 30336 | IL | |
| Registered Dietitian | 133V00000X | LD001552 | GA | Primary |
Addresses
Primary practice location
1826 Veterans Blvd
Dublin, GA 31021-3620
Mailing address
2201 Kings Dr
Dublin, GA 31021-2884
Phone (478) 272-1210
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 303362 | Other | REGISTERED DIETITIAN | |
| LD001552 | Other | GA | LICENSED DIETITIAN |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD001552 | GA | MD | Registered Dietitian |
| 30336 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275625089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 KINGS DR",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310212884",
"telephone_number": "478-272-1210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1826 VETERANS BLVD",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310213620",
"telephone_number": "478-272-1210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUTLAW",
"first_name": "JOYCE",
"middle_name": "ELAINE",
"credential": "R.D. L.D. M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "30336",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD001552",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DIETITIAN",
"identifier": "303362",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED DIETITIAN",
"identifier": "LD001552",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dublin, GA
Sources for this page
- 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.