Active NPI
Samara Joy Taylor Heller, RD, RDN
- Registered Dietitian
- Rancho Mission Viejo, CA
National Provider Identifier
1376300905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86087165
- Practice address
- 28806 Airoso St Unit 102
Rancho Mission Viejo, CA 92694-1885 - Phone
- (714) 299-3344
- NPI assigned
- Feb 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 86087165 | CA | Primary |
Addresses
Primary practice location
28806 Airoso St Unit 102
Rancho Mission Viejo, CA 92694-1885
Mailing address
28806 Airoso St Unit 102
Rancho Mission Viejo, CA 92694-1885
Phone (714) 299-3344
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86087165 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709164800000",
"number": "1376300905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28806 AIROSO ST UNIT 102",
"city": "RANCHO MISSION VIEJO",
"state": "CA",
"postal_code": "926941885",
"telephone_number": "714-299-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28806 AIROSO ST UNIT 102",
"city": "RANCHO MISSION VIEJO",
"state": "CA",
"postal_code": "926941885",
"telephone_number": "714-299-3344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR HELLER",
"first_name": "SAMARA",
"middle_name": "JOY",
"credential": "RD, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-29",
"last_updated": "2024-02-29",
"certification_date": "2024-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86087165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.