Individual provider Active NPI

Raleighetta Vonzell Varnedoe, MS, RD, LD

  • Registered Dietitian
  • Fort Stewart, GA
National Provider Identifier
1306847736
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD000935 Issued in GA
Practice address
1061 Harmon Ave
Winn Army Community Hospital - Nutrition Care Division
Fort Stewart, GA 31314-5674
Phone
(912) 435-6707
Fax
(912) 435-6791
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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 LD000935 GA Primary

Addresses

Primary practice location

1061 Harmon Ave
Winn Army Community Hospital - Nutrition Care Division
Fort Stewart, GA 31314-5674

Mailing address

1061 Harmon Ave
Ste 1D03
Fort Stewart, GA 31314-5641
Phone (912) 435-6707

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

LicenseStateTypeSpecialty
LD000935GAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1306847736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "STE 1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "WINN ARMY COMMUNITY HOSPITAL - NUTRITION CARE DIVISION",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145674",
            "telephone_number": "912-435-6707",
            "fax_number": "912-435-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNEDOE",
        "first_name": "RALEIGHETTA",
        "middle_name": "VONZELL",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD000935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stewart, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.