Active NPI
Lorenzo Gomez, RD
- Registered Dietitian
- Tifton, GA
National Provider Identifier
1306323415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD004779
- Practice address
- 901 18TH St E
Tifton, GA 31794-3648 - Phone
- (229) 353-6165
- NPI assigned
- Jul 21, 2018
- Sex
- Male
- 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 | LD004779 | GA | Primary |
Addresses
Primary practice location
901 18TH St E
Tifton, GA 31794-3648
Mailing address
PO Box 716
Omega, GA 31775-0716
Phone (229) 520-2217
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 |
|---|---|---|---|
| LD004779 | GA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532131200000",
"number": "1306323415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 716",
"city": "OMEGA",
"state": "GA",
"postal_code": "317750716",
"telephone_number": "229-520-2217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 18TH ST E",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943648",
"telephone_number": "229-353-6165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "LORENZO",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-21",
"last_updated": "2018-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD004779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.