Active NPI
Tasrina Dowla Dara, RD
- Registered Dietitian
- Fridley, MN
National Provider Identifier
1417025453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2555
- Practice address
- 550 Osborne Rd NE
Fridley, MN 55432-2718 - Phone
- (763) 236-3168
- NPI assigned
- Nov 30, 2006
- Last updated
- Jul 8, 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 | 2555 | MN | Primary |
Addresses
Primary practice location
550 Osborne Rd NE
Fridley, MN 55432-2718
Mailing address
16125 Xylite St NE
Ham Lake X, MN 55304-5724
Phone (763) 502-6686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 964412 | Other | ADA REGISTRATION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2555 | MN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417025453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16125 XYLITE ST NE",
"city": "HAM LAKE X",
"state": "MN",
"postal_code": "553045724",
"telephone_number": "763-502-6686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 OSBORNE RD NE",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554322718",
"telephone_number": "763-236-3168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARA",
"first_name": "TASRINA",
"middle_name": "DOWLA",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "2555",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADA REGISTRATION",
"identifier": "964412",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.