Individual provider Active NPI

Verne Shizuo Futagawa, RD

  • Registered Dietitian
  • Sheppard Afb, TX
National Provider Identifier
1295897262
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
939 Missile Rd
Sheppard Afb, TX 76311-2263
Phone
(940) 676-6617
Fax
(940) 676-3850
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

939 Missile Rd
Sheppard Afb, TX 76311-2263

Mailing address

113 Jupiter St
Sheppard Afb, TX 76311-1011
Phone (940) 851-8564

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

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295897262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 JUPITER ST",
            "city": "SHEPPARD AFB",
            "state": "TX",
            "postal_code": "763111011",
            "telephone_number": "940-851-8564",
            "fax_number": "940-851-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 MISSILE RD",
            "city": "SHEPPARD AFB",
            "state": "TX",
            "postal_code": "763112263",
            "telephone_number": "940-676-6617",
            "fax_number": "940-676-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUTAGAWA",
        "first_name": "VERNE",
        "middle_name": "SHIZUO",
        "name_prefix": "Mr.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheppard Afb, TX

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.

Verify at the official NPI Registry.