Individual provider Active NPI

Brooke Lancaster, RDN, LD

  • Registered Dietitian
  • Evansville, IN
National Provider Identifier
1508301862
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
37002988A Issued in IN
Practice address
4918 Temple Ave Ste G
Evansville, IN 47715-8502
Phone
(317) 385-9454
Fax
(812) 461-6999
NPI assigned
Dec 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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 11655 FL
Registered Dietitian 133V00000X 37002988A IN Primary

Addresses

Primary practice location

4918 Temple Ave Ste G
Evansville, IN 47715-8502

Mailing address

4918 Temple Ave Ste G
Evansville, IN 47715-8502

Other practice location 1

918 Lucerne Ter
Orlando, FL 32806-1013
Phone (407) 894-1444

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
11655FLMDRegistered Dietitian
37002988AINMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutritious Lifestyles, Inc. Dietitian, Registered Past Accepting new patients
Stanton Nutrition Counseling Dietitian, Registered PastSince Jan 8, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1508301862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4918 TEMPLE AVE STE G",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4918 TEMPLE AVE STE G",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158502",
            "telephone_number": "317-385-9454",
            "fax_number": "812-461-6999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "918 Lucerne Ter",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061013",
            "country_code": "US",
            "telephone_number": "407-894-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "BROOKE",
        "credential": "RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "11655",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37002988A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.