Active NPI
Stephanie Dawn Brooks, MS, RD, CEDRD
- Registered Dietitian
- Campbell, CA
National Provider Identifier
1598889545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 441 N Central Ave Ste 2a
Campbell, CA 95008-1428 - Phone
- (408) 370-7731
- Fax
- (408) 370-7732
- NPI assigned
- Mar 16, 2007
- Last updated
- May 25, 2021
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
441 N Central Ave Ste 2a
Campbell, CA 95008-1428
Mailing address
441 N Central Ave Ste 2a
Campbell, CA 95008-1428
Phone (408) 370-7731
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ24929Z | Other | CA | REGISTERED DIETITIAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Registered Dietitian
- Campbell, CA
- NPI 1477677425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1598889545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 N CENTRAL AVE STE 2A",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950081428",
"telephone_number": "408-370-7731",
"fax_number": "408-370-7732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 N CENTRAL AVE STE 2A",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950081428",
"telephone_number": "408-370-7731",
"fax_number": "408-370-7732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "STEPHANIE",
"middle_name": "DAWN",
"credential": "MS, RD, CEDRD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DIETITIAN",
"identifier": "ZZZ24929Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.