Beverly Lynn Prentice, M.S., R.D., L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1488 Issued in OK

Practice address

10105 Bridgewater Cir
Owasso, OK 74055-7727

Phone

(918) 272-4267

Fax

(918) 274-4227

NPI assigned

Jan 26, 2007

Sex

Female

Sole proprietor

Yes

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 OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Nutrition Specialists of Northeastern Oklahoma

  • Registered Dietitian
  • Tulsa, OK
  • NPI 1902299639

  Dietitian, Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528114873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 BRIDGEWATER CIR",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740557727",
            "telephone_number": "918-272-4267",
            "fax_number": "918-274-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 BRIDGEWATER CIR",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740557727",
            "telephone_number": "918-272-4267",
            "fax_number": "918-274-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENTICE",
        "first_name": "BEVERLY",
        "middle_name": "LYNN",
        "credential": "M.S., R.D., L.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Owasso, OK
• Providers in Owasso, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.