Stephanie Nelson Petrosky, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND000373 Issued in FL

Practice address

3200 S University Dr
Davie, FL 33328-2018

Phone

(954) 262-1597

NPI assigned

Apr 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nova Southeastern University, Inc

  • Optometrist
  • Ft. Lauderdale, FL
  • NPI 1700924511
  Medicare reassignment Care Compare group NPD
• Nova Southeastern University Inc.

  • Clinical Medical Laboratory
  • Ft. Lauderdale, FL
  • NPI 1770533390
  NPD
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517

  Nutritionist

  NPD

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1679152862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 SW 36TH ST",
            "address_2": "DEPARTMENT OF NUTRITION",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333281902",
            "telephone_number": "954-262-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSKY",
        "first_name": "STEPHANIE",
        "middle_name": "NELSON",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND000373",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "FL",
            "license": "ND000373",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND000373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.intellichart.com/NSUHealthClinics/",
            "affiliation": "N",
            "address_1": "3200 S University Dr",
            "city": "Davie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333282018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexa Peterson
• Shianna Peterson
• Lorane Petit-Louis
• Maritha Petit-Raymond
• Lucsnie Petit
• Helena Pew
• Steven J Pfister, PT
• Hoai-Quoc Pham
• Paula Phan
• Ryan Phan

• Registered Dietitian in Davie, FL
• Providers in Davie, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.