Individual provider Active NPI

Virginia Porter Trammell, RD/LD

  • Registered Dietitian
  • Broken Arrow, OK
National Provider Identifier
1477106300
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2426 Issued in OK
Practice address
4308 W Edgewater St
Broken Arrow, OK 74012-9433
Phone
(918) 645-3353
NPI assigned
Jul 19, 2019
Last updated
Jul 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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 2426 OK Primary

Addresses

Primary practice location

4308 W Edgewater St
Broken Arrow, OK 74012-9433

Mailing address

4308 W Edgewater St
Broken Arrow, OK 74012-9433
Phone (918) 645-3353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210915000857 OK Practitioner - Registered Dietitian Or Nutrition Professional 3375949423 Reassigns benefits to 1 organization
Practice locations: Owasso, OK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Specialists of Northeastern Oklahoma Dietitian, Registered CurrentSince Jun 18, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1477106300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 W EDGEWATER ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740129433",
            "telephone_number": "918-645-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 W EDGEWATER ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740129433",
            "telephone_number": "918-645-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAMMELL",
        "first_name": "VIRGINIA",
        "middle_name": "PORTER",
        "name_prefix": "Miss",
        "credential": "RD/LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.