Individual provider Active NPI

Lindsay R Vettleson, RDLD

  • Registered Dietitian
  • Fargo, ND
National Provider Identifier
1619157302
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
624 Issued in ND
Practice address
1707 Gold Dr S Ste 101
Fargo, ND 58103-6413
Phone
(701) 280-2033
Fax
(701) 232-5578
NPI assigned
Nov 9, 2007
Last updated
Feb 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 624 ND Primary
Registered Dietitian 133V00000X

Addresses

Primary practice location

1707 Gold Dr S Ste 101
Fargo, ND 58103-6413

Mailing address

1707 Gold Dr S Ste 101
Fargo, ND 58103-6413
Phone (701) 280-2033

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

LicenseStateTypeSpecialty
624NDMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1619157302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 GOLD DR S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036413",
            "telephone_number": "701-280-2033",
            "fax_number": "701-232-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 GOLD DR S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036413",
            "telephone_number": "701-280-2033",
            "fax_number": "701-232-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTLESON",
        "first_name": "LINDSAY",
        "middle_name": "R",
        "credential": "RDLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-09",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "624",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.