Individual provider Active NPI

Deborah Sue Eberle, RD LDN

  • Registered Dietitian
  • Kittanning, PA
National Provider Identifier
1447202767
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN002339 Issued in PA
Practice address
104 Parkview Dr
Suite 1
Kittanning, PA 16201-7105
Phone
(844) 328-9473
Fax
(724) 545-7233
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X DN002339 PA
Registered Dietitian 133V00000X DN002339 PA Primary

Addresses

Primary practice location

104 Parkview Dr
Suite 1
Kittanning, PA 16201-7105

Mailing address

104 Parkview Dr
Suite 1
Kittanning, PA 16201-7105
Phone (844) 328-9473

Other identifiers 1

IdentifierTypeStateIssuer
101187023MedicaidPA

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

State licenses

LicenseStateTypeSpecialty
DN002339PAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1447202767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PARKVIEW DR",
            "address_2": "SUITE 1",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017105",
            "telephone_number": "844-328-9473",
            "fax_number": "724-545-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PARKVIEW DR",
            "address_2": "SUITE 1",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017105",
            "telephone_number": "844-328-9473",
            "fax_number": "724-545-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLE",
        "first_name": "DEBORAH",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "RD LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PA",
            "license": "DN002339",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN002339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101187023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittanning, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.