Active NPI
Tara Beth Johnson, MS, RD, LD
- Registered Dietitian
- Ft Sill, OK
National Provider Identifier
1669741526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1878
- Practice address
- 4301 Wilson Street
Reynolds Army Community Hospital
Ft Sill, OK 75303 - Phone
- (580) 558-2825
- NPI assigned
- Dec 22, 2011
- 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 | 1878 | OK | Primary |
Addresses
Primary practice location
4301 Wilson Street
Reynolds Army Community Hospital
Ft Sill, OK 75303
Mailing address
4301 Wilson Street
Reynolds Army Community Hospital
Ft Sill, OK 75303
Phone (580) 558-2825
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 243345 | Other | ACADEMY OF LACTATION POLICY AND PRACTICE |
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)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530489600000",
"number": "1669741526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 WILSON STREET",
"address_2": "REYNOLDS ARMY COMMUNITY HOSPITAL",
"city": "FT SILL",
"state": "OK",
"postal_code": "75303",
"telephone_number": "580-558-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 WILSON STREET",
"address_2": "REYNOLDS ARMY COMMUNITY HOSPITAL",
"city": "FT SILL",
"state": "OK",
"postal_code": "75303",
"telephone_number": "580-558-2825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "TARA",
"middle_name": "BETH",
"credential": "MS, RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-22",
"last_updated": "2018-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1878",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACADEMY OF LACTATION POLICY AND PRACTICE",
"identifier": "243345",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ft Sill, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.