Individual provider Active NPI

Barbara Eutsey Oldham

  • Registered Dietitian
  • Smyrna, GA
National Provider Identifier
1336753474
Registry record updated Sep 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD004671 Issued in GA
Practice address
4045 Orchard Rd SE Ste 230
Smyrna, GA 30080-4905
Phone
(770) 693-8618
NPI assigned
Sep 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X LD004671 GA Primary

Addresses

Primary practice location

4045 Orchard Rd SE Ste 230
Smyrna, GA 30080-4905

Mailing address

2100 Towne Manor Dr NW
Kennesaw, GA 30144-2931

Other names 1

  • Barbara Dee Eutsey Former name

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

LicenseStateTypeSpecialty
LD004671GAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1599264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1336753474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 TOWNE MANOR DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 ORCHARD RD SE STE 230",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804905",
            "telephone_number": "770-693-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "BARBARA",
        "middle_name": "EUTSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-05",
        "last_updated": "2020-09-05",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD004671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BARBARA",
            "last_name": "EUTSEY",
            "middle_name": "DEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2020; 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.