Stephanie Fleetwood Deivert, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN003387 Issued in PA

Practice address

521 Mt Pleasant Dr
Scranton, PA 18503-1993

Phone

(570) 342-8500

Fax

(570) 558-2290

NPI assigned

May 30, 2006

Last updated

Dec 24, 2020By the provider in NPPES

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

Other names 1

• Stephanie Fleetwood Yeager Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1609823087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "CREDENTIALS DEPT",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MT PLEASANT DR",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031993",
            "telephone_number": "570-342-8500",
            "fax_number": "570-558-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIVERT",
        "first_name": "STEPHANIE",
        "middle_name": "FLEETWOOD",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN003387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdeivert80123@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "521 Mt Pleasant Dr",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185031993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "YEAGER",
            "middle_name": "FLEETWOOD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Louis Patrick Degennaro, M.D.
• Anthony Christopher Degrazia, DPT
• Bethany Dorothy Mary Degroat
• Mariah Deibert, PHARMD
• David Joshua Deisher, D.O.
• David R Delaplane, MD
• Michael Delaunay, LSW
• Maria Katherine Deleo, PA-C
• Mark Joseph Deleo, PA
• Ryan Carl Dell'Aglio, D.M.D

• Registered Dietitian in Scranton, PA
• Providers in Scranton, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.