Individual provider Active NPI

Molly Tarby, RD

  • Registered Dietitian
  • Anchorage, AK
National Provider Identifier
1477863140
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
212 Issued in AK
Practice address
3220 Providence Dr
Suite E3-030
Anchorage, AK 99508-4679
Phone
(907) 212-7982
Fax
(907) 212-7981
NPI assigned
Oct 15, 2010
Last updated
Oct 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 212 AK Primary
Pediatric Nutrition Registered Dietitian 133VN1004X LD0780 NM

Addresses

Primary practice location

3220 Providence Dr
Suite E3-030
Anchorage, AK 99508-4679

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Other identifiers 1

IdentifierTypeStateIssuer
1619753MedicaidAK

Other names 1

  • Molly Krehlik Former name

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

State licenses

LicenseStateTypeSpecialty
LD0780NMMDPediatric Nutrition Registered Dietitian
212AKMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1477863140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 PROVIDENCE DR",
            "address_2": "SUITE E3-030",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084679",
            "telephone_number": "907-212-7982",
            "fax_number": "907-212-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARBY",
        "first_name": "MOLLY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "212",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NM",
            "license": "LD0780",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619753",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "KREHLIK",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.