Stacy D Peters, M.S., R.D., L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT07584 Issued in TX

Practice address

4810 N Loop 289
Lubbock, TX 79416-3025

Phone

(806) 472-5325

Fax

(806) 687-7778

NPI assigned

Jul 30, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1407012321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 79TH PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794232409",
            "telephone_number": "806-470-3489",
            "fax_number": "806-687-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 N LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163025",
            "telephone_number": "806-472-5325",
            "fax_number": "806-687-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "STACY",
        "middle_name": "D",
        "credential": "M.S., R.D., L.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT07584",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "LD0639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dakota James Perry
• Elyse Michele Perry
• Kim E Pershall, MD
• Lauren Helen Pert, MD
• Peterman Orthotics & Prosthetics LLC (Advanced Limb & Brace)
• Susan Delaine Peters, RDH
• Darrin Odell Peterson, O.D.
• Jayman Disean Peterson, DPT
• Phyllis Rose Peterson, PA
• Ailyn Petit Hanke, HIS

• Registered Dietitian in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.