Active NPI
Holly Ann Herzfeld-Van Dyke, RD,MS,LD,CDE
- Metabolic Nutrition Registered Dietitian
- Conway, AR
National Provider Identifier
1336817469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- License
- 0783
- Practice address
- 3230-1 Lizzy Lane
Conway, AR 72032 - Phone
- (501) 818-9060
- NPI assigned
- Sep 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 0783 | AR | Primary |
Addresses
Primary practice location
3230-1 Lizzy Lane
Conway, AR 72032
Mailing address
PO Box 1811
Conway, AR 72033-1811
Phone (501) 818-9060
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 |
|---|---|---|---|
| 0783 | AR | MD | Metabolic Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645142400000",
"number": "1336817469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1811",
"city": "CONWAY",
"state": "AR",
"postal_code": "720331811",
"telephone_number": "501-818-9060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3230-1 LIZZY LANE",
"city": "CONWAY",
"state": "AR",
"postal_code": "72032",
"telephone_number": "501-818-9060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERZFELD-VAN DYKE",
"first_name": "HOLLY",
"middle_name": "ANN",
"credential": "RD,MS,LD,CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-02",
"last_updated": "2022-02-18",
"certification_date": "2022-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "AR",
"license": "0783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.