Active NPI
Alexandra Beliso
- Registered Dietitian
- Hazlehurst, GA
National Provider Identifier
1639717796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 30 E Sycamore St
Hazlehurst, GA 31539-6162 - Phone
- (912) 375-2425
- NPI assigned
- Dec 19, 2019
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
30 E Sycamore St
Hazlehurst, GA 31539-6162
Mailing address
604 Riverside Ave
Waycross, GA 31501-5323
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576713600000",
"number": "1639717796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 RIVERSIDE AVE",
"city": "WAYCROSS",
"state": "GA",
"postal_code": "315015323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E SYCAMORE ST",
"city": "HAZLEHURST",
"state": "GA",
"postal_code": "315396162",
"telephone_number": "912-375-2425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELISO",
"first_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-19",
"last_updated": "2019-12-19",
"certification_date": "2019-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazlehurst, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.