Active NPI
Detrick S Snyder, RDN
- Registered Dietitian
- Denver, CO
National Provider Identifier
1568154037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86105803
- Practice address
- 5001 Vallejo St
Denver, CO 80221-1363 - Phone
- (720) 648-6701
- NPI assigned
- May 23, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86105803 | CO | Primary |
Addresses
Primary practice location
5001 Vallejo St
Denver, CO 80221-1363
Mailing address
5001 Vallejo St
Denver, CO 80221-1363
Phone (720) 648-6701
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86105803 | CO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1568154037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5001 VALLEJO ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802211363",
"telephone_number": "720-648-6701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 VALLEJO ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802211363",
"telephone_number": "720-648-6701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNYDER",
"first_name": "DETRICK",
"middle_name": "S",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-23",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "86105803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.