Dietitiansabq

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

DIETITIANSABQ

Practice address

5203 Juan Tabo Blvd NE
Suite 2E
Albuquerque, NM 87111-2683

Phone

(505) 266-6121

NPI assigned

Jun 10, 2015

Organization subpart

Yes

Parent organization

EATING DISORDERS TREATMENT CENTERAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Keys

Title

Executive Director

Phone

(505) 273-2512

Specialties & licenses 1

Addresses

Part of

Eating Disorders Treatment Center LLC

Locations

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1588045033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 JUAN TABO BLVD NE",
            "address_2": "SUITE 2E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 JUAN TABO BLVD NE",
            "address_2": "SUITE 2E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112683",
            "telephone_number": "505-266-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETITIANSABQ",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EATING DISORDERS TREATMENT CENTER",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "KEYS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-273-2512"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean M Diener, NP
• Kathy Dieruf, PT
• Elizabeth Diesel, LMSW
• Timothy Sean Diesel, DOM, PA-C
• Daniel John Dieterichs, OD
• Charles Dietl, MD
• Matthias A Dietrich
• Christine Dietz, PT
• Dale D. Dietz, LCSW
• Hannah Lee Dietz

• Registered Dietitian in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Registered Dietitian in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.