Active NPI
Estefania Estrada Tutwiler, MS, RDN, LDN
- Registered Dietitian
- Madison, MS
National Provider Identifier
1396579017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-2470
- Practice address
- 212 Traceland Dr
Madison, MS 39110-8934 - Phone
- (205) 792-6390
- NPI assigned
- Aug 26, 2024
- Sex
- Female
- Sole proprietor
- No
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 | D-2470 | MS | Primary |
Addresses
Primary practice location
212 Traceland Dr
Madison, MS 39110-8934
Mailing address
212 Traceland Dr
Madison, MS 39110-8934
Phone (205) 792-6390
Other names 1
- Estefania Estrada
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-2470 | MS | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1724630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1396579017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 TRACELAND DR",
"city": "MADISON",
"state": "MS",
"postal_code": "391108934",
"telephone_number": "205-792-6390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 TRACELAND DR",
"city": "MADISON",
"state": "MS",
"postal_code": "391108934",
"telephone_number": "205-792-6390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUTWILER",
"first_name": "ESTEFANIA",
"middle_name": "ESTRADA",
"name_prefix": "Mrs.",
"credential": "MS, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-26",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MS",
"license": "D-2470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ESTEFANIA",
"last_name": "ESTRADA",
"credential": "MS, RDN, LDN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Madison, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.