Active NPI
Pamela Jean Averill, RD
- Registered Dietitian
- Indianapolis, IN
National Provider Identifier
1346458353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37001269A
- Practice address
- 3838 N Rural St
Indianapolis, IN 46205-2930 - Phone
- (317) 221-2306
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37001269A | IN | MD | Registered Dietitian |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 37001269A | IN | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
3838 N Rural St
Indianapolis, IN 46205-2930
Mailing address
30 N 6TH St
Zionsville, IN 46077-1350
Phone (317) 873-5704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346458353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N 6TH ST",
"city": "ZIONSVILLE",
"state": "IN",
"postal_code": "460771350",
"telephone_number": "317-873-5704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3838 N RURAL ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462052930",
"telephone_number": "317-221-2306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERILL",
"first_name": "PAMELA",
"middle_name": "JEAN",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37001269A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
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.