Individual provider Active NPI

Lindsay Queen, MS, RD, LD

  • Registered Dietitian
  • Benton, AR
National Provider Identifier
1679084404
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1565 Issued in AR
Practice address
1 Medical Park Dr
Benton, AR 72015-3353
Phone
(501) 776-6106
NPI assigned
Oct 19, 2017
Last updated
Aug 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1565 AR Primary

Addresses

Primary practice location

1 Medical Park Dr
Benton, AR 72015-3353

Mailing address

1 Medical Park Dr
Benton, AR 72015-3353

Other practice location 1

895 Grant 69
Sheridan, AR 72150-8244
Phone (870) 405-4016

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

State licenses

LicenseStateTypeSpecialty
1565ARMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1679084404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153353",
            "telephone_number": "501-776-6106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "895 Grant 69",
            "address_purpose": "LOCATION",
            "city": "Sheridan",
            "state": "AR",
            "postal_code": "721508244",
            "country_code": "US",
            "telephone_number": "870-405-4016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "LINDSAY",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AR",
            "license": "1565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.

Verify at the official NPI Registry.