Active NPI
John Dodd, RD,CSR,LD
- Renal Nutrition Registered Dietitian
- Ormond Beach, FL
National Provider Identifier
1609189059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- ND 2189
- Practice address
- 123 Sandcastle Dr
Ormond Beach, FL 32176-4156 - Phone
- (386) 441-2090
- NPI assigned
- Jul 14, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | ND 2189 | FL | Primary |
Addresses
Primary practice location
123 Sandcastle Dr
Ormond Beach, FL 32176-4156
Mailing address
123 Sandcastle Dr
Ormond Beach, FL 32176-4156
Phone (386) 441-2090
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 |
|---|---|---|---|
| ND 2189 | FL | MD | Renal Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279065600000",
"number": "1609189059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 SANDCASTLE DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321764156",
"telephone_number": "386-441-2090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 SANDCASTLE DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321764156",
"telephone_number": "386-441-2090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODD",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "RD,CSR,LD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-14",
"last_updated": "2010-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "FL",
"license": "ND 2189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.