Angela D Siebenaller, RD,LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L004325 Issued in NC

Practice address

15 Regional Dr
Pinehurst, NC 28374-8850

Phone

(910) 295-5511

NPI assigned

Aug 8, 2016

Last updated

Aug 8, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Angela D Schalk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pinehurst Medical Clinic, Inc.

  dba PMC Reference Lab

  • Clinical Medical Laboratory
  • Southern Pines, NC
  • NPI 1962509372
  NPD (past)

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1346794443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PAGE RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748749",
            "telephone_number": "910-295-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REGIONAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748850",
            "telephone_number": "910-295-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBENALLER",
        "first_name": "ANGELA",
        "middle_name": "D",
        "credential": "RD,LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "SCHALK",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashwini Sheth, P.T.
• Kevin Shi
• Madeline Jane Shinn, PH.,D.
• John Paul Shoffeitt, M.D.
• Jeffery Preston Short, PA
• Ovidiu-Gabriel Silasi, M.D.
• Mary Silverman, LCSW
• Darrell Simpkins, MD
• Marcia Simpson, LCSW
• Patrick J Simpson, MD

• Registered Dietitian in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.