Erin Anne Stark, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86073959 Issued in MI

Practice address

311 State St SE
Grand Rapids, MI 49503-4312

Phone

(269) 729-5151

Fax

(833) 393-6789

NPI assigned

Jan 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nottawaseppi Huron Band of the PotawatomiGroup PAC ID 2769441286, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nottawaseppi Huron Band of the Potawatomi

  • Federal Public Health Clinic/Center
  • Wyoming, MI
  • NPI 1770500548

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1609349315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 STATE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034312",
            "telephone_number": "269-729-5151",
            "fax_number": "833-393-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 STATE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034312",
            "telephone_number": "269-729-5151",
            "fax_number": "833-393-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "ERIN",
        "middle_name": "ANNE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "86073959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86073959",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Joyce Stanton, LMSW, CAADC
• Lisa Staple, RN
• Cherina Dawn Johnson Staples, LPC
• Andrea Stark, MA, CCC-SLP
• Emily Marie Stark, LMSW
• Jeanne L Stark, LMSW
• Matthew Charles Starke, M.D.
• Elaine Rocio Starkey
• Starling Therapy
• Rubee Ann Starling, BEHAVIOR TECHNICIAN

• Registered Dietitian in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.