Individual provider Active NPI

Diana Lynne Rodenberg, R.D., C.D.E.

  • Registered Dietitian
  • Gladstone, MO
National Provider Identifier
1407932585
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2001025077 Issued in MO
Practice address
6420 N Prospect Ave
Gladstone, MO 64119-1530
Phone
(816) 842-4440
Fax
(816) 298-7904
NPI assigned
Oct 31, 2006
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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 2001025077 MO Primary

Addresses

Primary practice location

6420 N Prospect Ave
Gladstone, MO 64119-1530

Mailing address

6420 N Prospect Ave
Gladstone, MO 64119-1530
Phone (816) 842-4440

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Lukes East Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1407932585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 N PROSPECT AVE",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641191530",
            "telephone_number": "816-842-4440",
            "fax_number": "816-298-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 N PROSPECT AVE",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641191530",
            "telephone_number": "816-842-4440",
            "fax_number": "816-298-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENBERG",
        "first_name": "DIANA",
        "middle_name": "LYNNE",
        "credential": "R.D., C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2001025077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.