Active NPI
Sedona Kathryn Mazza
- Registered Dietitian
- Gardnerville, NV
National Provider Identifier
1619574647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 39837-DI-0
- Practice address
- 1513 Wildrose Dr
Gardnerville, NV 89410-5115 - Phone
- (775) 233-5217
- NPI assigned
- Oct 2, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 39837-DI-0 | NV | Primary |
Addresses
Primary practice location
1513 Wildrose Dr
Gardnerville, NV 89410-5115
Mailing address
1513 Wildrose Dr
Gardnerville, NV 89410-5115
Phone (775) 233-5217
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 |
|---|---|---|---|
| 39837-DI-0 | NV | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1619574647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1513 WILDROSE DR",
"city": "GARDNERVILLE",
"state": "NV",
"postal_code": "894105115",
"telephone_number": "775-233-5217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1513 WILDROSE DR",
"city": "GARDNERVILLE",
"state": "NV",
"postal_code": "894105115",
"telephone_number": "775-233-5217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZA",
"first_name": "SEDONA",
"middle_name": "KATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-02",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "39837-DI-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardnerville, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.