Individual provider Active NPI

Pamela Jean Averill, RD

  • Registered Dietitian
  • Indianapolis, IN
National Provider Identifier
1346458353
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
37001269A Issued in IN
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

LicenseStateTypeSpecialty
37001269AINMDRegistered Dietitian

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 37001269A IN Primary

Addresses

NPPES NPI Registry

Primary 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.

Verify at the official NPI Registry.