Individual provider Active NPI

Laurie A Schwanenberger, RD

  • Registered Dietitian
  • Tucson, AZ
National Provider Identifier
1376611145
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
804775 Issued in AZ
Practice address
6567 E Carondelet Dr Ste 555
Carondelet Medical Group
Tucson, AZ 85710
Phone
(520) 885-3588
Fax
(520) 290-3958
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 804775 AZ Primary

Addresses

Primary practice location

6567 E Carondelet Dr Ste 555
Carondelet Medical Group
Tucson, AZ 85710

Mailing address

2202 N. Forbes Blvd.
Tucson, AZ 85745
Phone (520) 872-7265

Other identifiers 1

IdentifierTypeStateIssuer
162704MedicaidAZ

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1376611145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 N. FORBES BLVD.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85745",
            "telephone_number": "520-872-7265",
            "fax_number": "520-872-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6567 E CARONDELET DR STE 555",
            "address_2": "CARONDELET MEDICAL GROUP",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85710",
            "telephone_number": "520-885-3588",
            "fax_number": "520-290-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWANENBERGER",
        "first_name": "LAURIE",
        "middle_name": "A",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "804775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162704",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.