Individual provider Active NPI

Darrin O Seybold, M.S., R.D.

  • Registered Dietitian
  • Alpharetta, GA
National Provider Identifier
1467565200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD002105 Issued in GA
Practice address
140 Ketton Way
Alpharetta, GA 30005-6481
Phone
(404) 674-5458
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD002105 GA Primary

Addresses

Primary practice location

140 Ketton Way
Alpharetta, GA 30005-6481

Mailing address

4305 State Bridge Rd
Suite 103-38
Alpharetta, GA 30022-4471
Phone (404) 674-5458

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LD002105GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Clinical Nutrition Centers, Inc. Dietitian, Registered Past Accepting new patients

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467565200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 STATE BRIDGE RD",
            "address_2": "SUITE 103-38",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300224471",
            "telephone_number": "404-674-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 KETTON WAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300056481",
            "telephone_number": "404-674-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYBOLD",
        "first_name": "DARRIN",
        "middle_name": "O",
        "credential": "M.S., R.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD002105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.