William R Procaccini, RD

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

ND5446 Issued in FL

Practice address

501 6TH Ave S
St Petersburg, FL 33701-4634

Phone

(727) 767-3578

Fax

(727) 767-4249

NPI assigned

Oct 14, 2014

Last updated

Oct 14, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1366846784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 6TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014634",
            "telephone_number": "727-767-3578",
            "fax_number": "727-767-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 6TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014634",
            "telephone_number": "727-767-3578",
            "fax_number": "727-767-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCACCINI",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "FL",
            "license": "ND5446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nutrition Registered Dietitian in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Pediatric Nutrition Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.