Active NPI
Misti Odefey, REGISTERED DIETICIAN
- Registered Dietitian
- Ruston, LA
National Provider Identifier
1356312698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 894367
- Practice address
- 1200 S Farmerville St
Ruston, LA 71270-5941 - Phone
- (318) 255-3690
- NPI assigned
- Jan 26, 2006
- Last updated
- Jul 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 894367 | LA | Primary |
Addresses
Primary practice location
1200 S Farmerville St
Ruston, LA 71270-5941
Mailing address
1200 S Farmerville St
Ruston, LA 71270-5941
Phone (318) 255-3690
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 894367 | LA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1356312698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 S FARMERVILLE ST",
"city": "RUSTON",
"state": "LA",
"postal_code": "712705941",
"telephone_number": "318-255-3690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 S FARMERVILLE ST",
"city": "RUSTON",
"state": "LA",
"postal_code": "712705941",
"telephone_number": "318-255-3690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODEFEY",
"first_name": "MISTI",
"name_prefix": "Ms.",
"credential": "REGISTERED DIETICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-26",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "894367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
- Northern Louisiana Emergency Physicians LLP (Northern Louisiana Physicians LLP)
- Northern Louisiana Emergency Physicians, LLP (Northern Louisiana Physicians LLP)
- Northland Hearing Centers, Inc. (Audibel Hearing Center)
- Northwood Medical Center
- Paul M Novakovich, MD
- Angela D Odom-Austin, M.D.
- Winter Deleen Oliver, FNP
- Danyelle McDaniel Oneal
- Orthopaedic Clinic of Monroe
- David Christian Osafo, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.