Individual provider Active NPI

Lynnette Severy, M.S., R.D., C.D.

  • Pediatric Nutrition Registered Dietitian
  • Tacoma, WA
National Provider Identifier
1467654954
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
DI00001496 Issued in WA
Practice address
7821 N 10TH St
Tacoma, WA 98406-1059
Phone
(603) 545-9766
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X DI00001496 WA Primary
Registered Dietitian 133V00000X 0639 NH

Addresses

Primary practice location

7821 N 10TH St
Tacoma, WA 98406-1059

Mailing address

7821 N 10TH St
Tacoma, WA 98406-1059
Phone (603) 545-9766

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0639NHMDRegistered Dietitian
DI00001496WAMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1467654954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7821 N 10TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984061059",
            "telephone_number": "603-545-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7821 N 10TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984061059",
            "telephone_number": "603-545-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERY",
        "first_name": "LYNNETTE",
        "credential": "M.S., R.D., C.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "WA",
            "license": "DI00001496",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": "0639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.