Individual provider Active NPI

Claire Pond Gundlach, MS, RDN, LD

  • Registered Dietitian
  • Arlington, TX
National Provider Identifier
1407359714
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86071548 Issued in TX
Practice address
422 E Lamar Blvd Ste 108
Arlington, TX 76011-3604
Phone
(817) 751-7802
NPI assigned
Mar 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86071548 TX Primary

Addresses

Primary practice location

422 E Lamar Blvd Ste 108
Arlington, TX 76011-3604

Mailing address

2217 Ivan St Apt 924
Dallas, TX 75201-7038

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86071548TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC CurrentSince May 5, 2021 Accepting new patients

Locations

422 E Lamar Blvd
Ste 108
Arlington, TX 76011
Phone (817) 751-7802

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": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1407359714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 IVAN ST APT 924",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 E LAMAR BLVD STE 108",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760113604",
            "telephone_number": "817-751-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDLACH",
        "first_name": "CLAIRE",
        "middle_name": "POND",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86071548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.