Active NPI
Carol E Ward, RD
- Registered Dietitian
- Star, ID
National Provider Identifier
1407071590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D185
- Practice address
- 2090 N Sunny LN
Star, ID 83669-5118 - Phone
- (208) 794-8648
- NPI assigned
- Apr 16, 2007
- 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 | D185 | ID | Primary |
Addresses
Primary practice location
2090 N Sunny LN
Star, ID 83669-5118
Mailing address
2090 N Sunny LN
Star, ID 83669-5118
Phone (208) 794-8648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0983730 | Medicaid | ID |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D185 | ID | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273190400000",
"number": "1407071590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2090 N SUNNY LN",
"city": "STAR",
"state": "ID",
"postal_code": "836695118",
"telephone_number": "208-794-8648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2090 N SUNNY LN",
"city": "STAR",
"state": "ID",
"postal_code": "836695118",
"telephone_number": "208-794-8648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARD",
"first_name": "CAROL",
"middle_name": "E",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2010-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "D185",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0983730",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Star, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.