Individual provider Active NPI

Beth E Stefura, RD.,LD

  • Pediatric Nutrition Registered Dietitian
  • Cortland, OH
National Provider Identifier
1417198714
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
716810 Issued in OH
Practice address
236 Old Oak Dr
Cortland, OH 44410-1122
Phone
(330) 727-6254
NPI assigned
Mar 16, 2009
Last updated
Mar 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X 716810 OH Primary

Addresses

Primary practice location

236 Old Oak Dr
Cortland, OH 44410-1122

Mailing address

236 Old Oak Dr
Cortland, OH 44410-1122
Phone (330) 727-6254

Other identifiers 1

IdentifierTypeStateIssuer
#BC00304OtherOHBCMH

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
716810OHMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1417198714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 OLD OAK DR",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444101122",
            "telephone_number": "330-727-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 OLD OAK DR",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444101122",
            "telephone_number": "330-727-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFURA",
        "first_name": "BETH",
        "middle_name": "E",
        "credential": "RD.,LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "OH",
            "license": "716810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "#BC00304",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.