Lauren Michelle Haddock, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-D-10192531 Issued in OR

Practice address

2371 NE Stephens St Ste 200
Roseburg, OR 97470-1399

Phone

(541) 672-8533

Fax

(541) 672-4993

NPI assigned

Sep 7, 2018

Last updated

Aug 20, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lauren Bentley Former name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lauren.haddock.1@17792.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Umpqua Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1396751772
  Medicare reassignment NPD
• Umpqua Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Glide, OR
  • NPI 1609065010
  NPD
• Umpqua Community Health Center, Inc.

  dba Aviva Health

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1720803810
  NPD
• Cow Creek Band of Umpqua Tribe of Indians

  dba Cow Creek Health & Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Canyonville, OR
  • NPI 1134567993
  NPD (past)

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1386127298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 ELGAROSE RD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974719092",
            "telephone_number": "541-817-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2371 NE STEPHENS ST STE 200",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701399",
            "telephone_number": "541-672-8533",
            "fax_number": "541-672-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "LAUREN",
        "middle_name": "MICHELLE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10192531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "BENTLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anjali Gupta, MD
• Wilson Sy Gutierrez, MD
• Dawnya Guyette
• Willie Dieago Haaby, B.S., CADC I
• Hariwan Ali Habib, PHARMD
• Gregory Allen Haines, MD
• Mohammed A a Halabiya, MD
• Nanette Faye Haley, OTR
• Kara Hall
• Marcia Ellen Hall, PHD, RN

• Registered Dietitian in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.