Active NPI
Laurie B Beebe, MS, RD, LD
- Metabolic Nutrition Registered Dietitian
- Granite City, IL
National Provider Identifier
1295954980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- License
- 164003260
- Practice address
- 2100 Madison Ave
Granite City, IL 62040-4701 - Phone
- (618) 798-3492
- Fax
- (618) 798-3871
- NPI assigned
- Apr 24, 2007
- 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 |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 164003260 | IL | Primary |
Addresses
Primary practice location
2100 Madison Ave
Granite City, IL 62040-4701
Mailing address
2100 Madison Ave
Granite City, IL 62040-4701
Phone (618) 798-3492
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164003260 | Other | IL | ILLINOIS LICENSE # |
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 |
|---|---|---|---|
| 164003260 | IL | MD | Metabolic Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295954980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 MADISON AVE",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620404701",
"telephone_number": "618-798-3492",
"fax_number": "618-798-3871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 MADISON AVE",
"city": "GRANITE CITY",
"state": "IL",
"postal_code": "620404701",
"telephone_number": "618-798-3492",
"fax_number": "618-798-3871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEEBE",
"first_name": "LAURIE",
"middle_name": "B",
"credential": "MS, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "IL",
"license": "164003260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS LICENSE #",
"identifier": "164003260",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Granite City, IL
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.