Patrick Lackmann Traynor, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86082088 Issued in CA

Practice address

3079 Harrison Ave
South Lake Tahoe, CA 96150

Phone

(909) 653-3471

Fax

(949) 269-0134

NPI assigned

Aug 8, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• MNT Scientific

  • Registered Dietitian
  • South Lake Tahoe, CA
  • NPI 1588347462

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1477236347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 RIVER RANCH ROAD",
            "city": "MARKLEEVILLE",
            "state": "CA",
            "postal_code": "96120",
            "telephone_number": "909-653-3471",
            "fax_number": "949-269-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3079 HARRISON AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "96150",
            "telephone_number": "909-653-3471",
            "fax_number": "949-269-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYNOR",
        "first_name": "PATRICK",
        "middle_name": "LACKMANN",
        "name_prefix": "Dr.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86082088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Through the Woods Individual and Child Therapy
• Cristie Teresita Tibbetts
• Timothy David Tonini, DO
• Danielle Trapani, DACM LAC
• Mary Kristine Travis, MS RD
• Triveda Health
• Julia Marie Trizuto
• Roderick Randolph Turner, MD
• Marta Tuznik
• Tyler Peterson DO Inc

• Registered Dietitian in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.