Individual provider Active NPI

Doreen Rodo, R.D.

  • Registered Dietitian
  • Bradenton, FL
National Provider Identifier
1386835973
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND7523 Issued in FL
Practice address
5317 4TH Ave Circle East
Bradenton, FL 34208-5623
Phone
(941) 254-4957
Fax
(941) 254-4958
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000721 CT
Registered Dietitian 133V00000X ND7523 FL Primary

Addresses

Primary practice location

5317 4TH Ave Circle East
Bradenton, FL 34208-5623

Mailing address

PO Box 637801
Att: Ipm Credentialing
Cincinnati, OH 45263-7801
Phone (775) 356-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108000531 TX Practitioner - Registered Dietitian Or Nutrition Professional 2567760481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND7523FLMDRegistered Dietitian
000721CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered CurrentSince Oct 29, 2024 Accepting new patients
Manatee Specialty Physician Alliance, LLC PastSince Mar 17, 2016 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

515 S Flower St
#1015
Los Angeles, CA 90071

401 N Michigan Ave
Ste 1200
Chicago, IL 60611
Phone (224) 496-6940

317 E Capitol St
Ste 200
Jackson, MS 39201
Phone (317) 510-0758

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

1806 Highway 35
Ste 203A
Oakhurst, NJ 07755

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1386835973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637801",
            "address_2": "ATT: IPM CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637801",
            "telephone_number": "775-356-9393",
            "fax_number": "775-356-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 4TH AVE CIRCLE EAST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085623",
            "telephone_number": "941-254-4957",
            "fax_number": "941-254-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODO",
        "first_name": "DOREEN",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "000721",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND7523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.