Individual provider Active NPI

Tammy Lantz, RD, LD

  • Registered Dietitian
  • Niceville, FL
National Provider Identifier
1417120007
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
921681 Issued in CO
Practice address
1435 Bayshore Dr
Niceville, FL 32578-3401
Phone
(850) 659-3557
NPI assigned
Apr 4, 2008
Last updated
Jul 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 921681 CO Primary
Registered Dietitian 133V00000X ND7399 FL
Pediatric Nutrition Registered Dietitian 133VN1004X 921681 CO
Lactation Consultant (Non-RN) 174N00000X 11190656 CO

Addresses

Primary practice location

1435 Bayshore Dr
Niceville, FL 32578-3401

Mailing address

1435 Bayshore Dr
Niceville, FL 32578-3401
Phone (850) 659-3557

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

LicenseStateTypeSpecialty
ND7399FLMDRegistered Dietitian
921681COMDPediatric Nutrition Registered Dietitian
11190656COMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1417120007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 BAYSHORE DR",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783401",
            "telephone_number": "850-659-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 BAYSHORE DR",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783401",
            "telephone_number": "850-659-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTZ",
        "first_name": "TAMMY",
        "credential": "RD,  LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "921681",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND7399",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "CO",
            "license": "921681",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CO",
            "license": "11190656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; 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.