Active NPI
Stacy Lea Walker, RD, LD
- Registered Dietitian
- Tulsa, OK
National Provider Identifier
1669797957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 997106
- Practice address
- 1334 N Lansing Ave
Tulsa, OK 74106-5907 - Phone
- (918) 587-2171
- Fax
- (918) 295-6194
- NPI assigned
- Mar 30, 2010
- 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 | 997106 | OK | Primary |
Addresses
Primary practice location
1334 N Lansing Ave
Tulsa, OK 74106-5907
Mailing address
1334 N Lansing Ave
Tulsa, OK 74106-5907
Phone (918) 587-2171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1653 | Other | OK | OKLA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION |
| 997106 | Other | OK | AMERICAN DIETETIC ASSOCIATION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 997106 | OK | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343606400000",
"number": "1669797957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1334 N LANSING AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741065907",
"telephone_number": "918-587-2171",
"fax_number": "918-295-6194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1334 N LANSING AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741065907",
"telephone_number": "918-587-2171",
"fax_number": "918-295-6194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "STACY",
"middle_name": "LEA",
"name_prefix": "Ms.",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-30",
"last_updated": "2012-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "997106",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION",
"identifier": "1653",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN DIETETIC ASSOCIATION",
"identifier": "997106",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.