Individual provider Active NPI

Dana Leslie Thompson, MS RD CNSC CDE

  • Metabolic Nutrition Registered Dietitian
  • Glendale, AZ
National Provider Identifier
1366785891
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Practice address
5722 W. Ludden Mt. Dr.
Glendale, AZ 85310-2748
Phone
(623) 879-0511
Fax
(623) 879-0522
NPI assigned
Apr 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Nutrition Education Nutritionist 133NN1002X
Registered Dietitian 133V00000X
Pediatric Nutrition Registered Dietitian 133VN1004X
Renal Nutrition Registered Dietitian 133VN1005X
Metabolic Nutrition Registered Dietitian 133VN1006X Primary

Addresses

Primary practice location

5722 W. Ludden Mt. Dr.
Glendale, AZ 85310-2748

Mailing address

5722 W. Ludden Mt. Dr.
Glendale, AZ 85310-2748
Phone (623) 879-0511

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

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1366785891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5722 W. LUDDEN MT. DR.",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853102748",
            "telephone_number": "623-879-0511",
            "fax_number": "623-879-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5722 W. LUDDEN MT. DR.",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853102748",
            "telephone_number": "623-879-0511",
            "fax_number": "623-879-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DANA",
        "middle_name": "LESLIE",
        "name_prefix": "Mrs.",
        "credential": "MS RD CNSC CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.