Alyssa Shaelyn Reidhead, RD

Individual provider Active NPI Registered Dietitian · Hyrum, UT

NPI 1447627484 · NPPES record last updated Jan 14, 2022

Key facts

NPI
1447627484
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
9539729-4901 (UT)
Practice address
128 S 1350 E
Hyrum, UT 84319-2029
Phone
(702) 423-7657
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Alyssa Reidhead Enterprises LLC Current
since Jan 21, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 9539729-4901 UT Yes

Addresses

Primary practice location

128 S 1350 E
Hyrum, UT 84319-2029

Mailing address

128 S 1350 E
Hyrum, UT 84319-2029
Phone (702) 423-7657

Other names

  • Alyssa Shaelyn O'Toole Former name

Other providers in Hyrum, UT

All providers in Hyrum, UT · Registered Dietitian in Utah

Sources for this page

Verify at the official NPI Registry.