Individual provider Active NPI

Lizette Taboada-Vance, RD

  • Nutritionist
  • Austin, TX
National Provider Identifier
1457482648
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
960797 Issued in TX
Practice address
1601 Trinity St
Austin, TX 78712-1765
Phone
(833) 882-2737
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 960797 TX Primary

Addresses

Primary practice location

1601 Trinity St
Austin, TX 78712-1765

Mailing address

11715 Oak Knoll Dr
Austin, TX 78759-3830
Phone (512) 897-0193

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
960797TXMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Any Baby Can of Austin, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lizette.taboada.1@16041.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1457482648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11715 OAK KNOLL DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787593830",
            "telephone_number": "512-897-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 TRINITY ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121765",
            "telephone_number": "833-882-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOADA-VANCE",
        "first_name": "LIZETTE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "TX",
            "license": "960797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.