Individual provider Active NPI

Beth Anne Lawrence, RDLD CDE

  • Registered Dietitian
  • Massillon, OH
National Provider Identifier
1538679808
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
5348 Issued in OH
Practice address
4941 Shady Knoll Ave NW
Massillon, OH 44646-9518
Phone
(330) 705-6040
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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 5348 OH Primary

Addresses

Primary practice location

4941 Shady Knoll Ave NW
Massillon, OH 44646-9518

Mailing address

4941 Shady Knoll Ave NW
Massillon, OH 44646-9518
Phone (330) 705-6040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180323001420 OH Practitioner - Registered Dietitian Or Nutrition Professional 2668734088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4565 Dressler Rd NW
Suite 111
Canton, OH 44718-2576
Phone (330) 493-0013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes & Endocrinology Associates of Stark County Incorporated CurrentSince Sep 30, 2019 Accepting new patients

Locations

4565 Dressler Rd NW
Ste 111
Canton, OH 44718
Phone (216) 493-0013

Organizations & group practices 1

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1538679808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4941 SHADY KNOLL AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469518",
            "telephone_number": "330-705-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4941 SHADY KNOLL AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469518",
            "telephone_number": "330-705-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "BETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "RDLD CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "5348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.