Jill Anne Tanaka, REGISTERED DIETICIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT80417 Issued in TX

Practice address

4607 Manchaca Rd
Austin, TX 78745-1607

Phone

(512) 916-1511

NPI assigned

Aug 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kidtherapy, PLLC

  • Pediatric Physical Therapist
  • Austin, TX
  • NPI 1124213046
  NPD (past)

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1598959801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 MANCHACA RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451607",
            "telephone_number": "512-916-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 MANCHACA RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451607",
            "telephone_number": "512-916-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "JILL",
        "middle_name": "ANNE",
        "credential": "REGISTERED DIETICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT80417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eng Kheng Tan, L.AC., LMT
• Shengyan Grace Tan, LAC
• Thelma Tan, DMD
• Thomas Tan, MD
• Tana M Busch DDS PLLC
• Tarushi Tanaya, MD
• Tandem Speech Therapy, PLLC
• Irwin A. Tang, LPC, MA, MFA
• Lauren Tang
• Linh Lien Tang, O.D.

• Registered Dietitian in Austin, TX
• Providers in Austin, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.