Traci J Stamatakos, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD.6187 Issued in OH

Practice address

222 Piedmont Ave
Cincinnati, OH 45219-4231

Phone

(513) 475-8523

Fax

(513) 475-7327

NPI assigned

Feb 5, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Traci Jeanette. Jerkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Internal Medicine Associates, Inc.

  • Internal Medicine Physician
  • Cincinnati, OH
  • NPI 1588620850
  NPD (past)
• University of Cincinnati Physicians, Inc.

  • Internal Medicine Physician
  • Cincinnati, OH
  • NPI 1417108697
  NPD (past)

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1669650446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "address_2": "CENTRAL CREDENTALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-245-3104",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452194231",
            "telephone_number": "513-475-8523",
            "fax_number": "513-475-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMATAKOS",
        "first_name": "TRACI",
        "middle_name": "J",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LP.10285-A",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD.6187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "JERKINS",
            "middle_name": "JEANETTE.",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jerrhonda Anne Stallworth
• Milashey Lafayette Stallworth
• Nyrie Stallworth
• Rion Stallworth, RN
• Samantha Latosha Stallworth
• Nancy Roberta Stambough, RPH
• Eric Franklin Stamler, M.D.
• Robyn Stamm, RN, CNP
• Amy Stamper
• Janielle Stampley

• Registered Dietitian in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; 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.