Individual provider Active NPI

Robert Summerford, RD, CD

  • Registered Dietitian
  • Kirkland, WA
National Provider Identifier
1487025979
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
603549244 Issued in WA
Practice address
2260 Carillon PT
Kirkland, WA 98033-7446
Phone
(323) 251-0603
NPI assigned
Oct 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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 603549244 WA Primary

Addresses

Primary practice location

2260 Carillon PT
Kirkland, WA 98033-7446

Mailing address

3603 213TH PL SE
Bothell, WA 98021-7063

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

State licenses

LicenseStateTypeSpecialty
603549244WAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1487025979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3603 213TH PL SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 CARILLON PT",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337446",
            "telephone_number": "323-251-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERFORD",
        "first_name": "ROBERT",
        "credential": "RD, CD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "603549244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.