Emily Petty, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

114 Ironweed Dr
Pueblo, CO 81001-1070

Phone

(405) 371-1695

NPI assigned

Oct 20, 2023

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

Other names 1

• Emily Womack Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1548042799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 IRONWEED DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011070",
            "telephone_number": "405-371-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 IRONWEED DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011070",
            "telephone_number": "405-371-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "EMILY",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "WOMACK",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angelo Petriello, DPT
• Melanie Pettengill
• Ashley Pettijohn
• Josh Pettinari
• Laura Evelyn Pettit, FNP-C
• Timothy David Petty, DMD
• Michael Pfannenstiel, M.D.
• Christine Marie Phalen, B.S.N.
• Nghi Pham
• Ashley Jo Phelps, PHD

• Registered Dietitian in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.