Stacey Orner, RD, LD, MFN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND7649 Issued in FL

Practice address

62 Boylston CT
St Augustine, FL 32092-0088

Phone

(216) 650-2766

NPI assigned

Jun 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1437835162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BOYLSTON CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920088",
            "telephone_number": "216-650-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BOYLSTON CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920088",
            "telephone_number": "216-650-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORNER",
        "first_name": "STACEY",
        "name_prefix": "Mrs.",
        "credential": "RD, LD, MFN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "1091197",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND7649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Medical PLLC
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• Jacqueline Atamba Ongayo
• Eric Ordonez, PTA
• Kristen Orlando
• Anna Katharine Ortega
• Ortho Visits LLC
• Orthonorthrup PA
• Orthopaedic Assoc of St Augustine PA
• Louise Osborn, LM, CPM, LMHC

• Registered Dietitian in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.