NPIMap

Organization Active NPI

Az Diabetes Education, LLC

  • Registered Dietitian
  • Mesa, AZ
National Provider Identifier
1629526595
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
AZ DIABETES EDUCATION, LLC
Practice address
2309 E Lynwood St
Mesa, AZ 85213-2229
Phone
(480) 593-9348
Fax
(480) 834-4405
NPI assigned
Sep 20, 2016
Last updated
Oct 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Authorized official

Name
Audrey A Lally, MS RDN CDENPI 1215481650
Title
Ceo
Phone
(480) 593-9348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

2309 E Lynwood St
Mesa, AZ 85213-2229

Mailing address

2309 E Lynwood St
Mesa, AZ 85213-2229
Phone (480) 593-9348

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1629526595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 E LYNWOOD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852132229",
            "telephone_number": "480-593-9348",
            "fax_number": "480-834-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 E LYNWOOD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852132229",
            "telephone_number": "480-593-9348",
            "fax_number": "480-834-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ DIABETES EDUCATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "LALLY",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-593-9348",
        "authorized_official_credential": "MS RDN CDE"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.