Individual provider Active NPI

Bonnie Beth Hauenstein, R.D., L.D.

  • Registered Dietitian
  • Bridgeton, MO
National Provider Identifier
1679822712
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2011036331 Issued in MO
Practice address
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone
(314) 344-7961
NPI assigned
Sep 5, 2012
Last updated
Sep 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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 2011036331 MO Primary

Addresses

Primary practice location

12303 De Paul Dr
Bridgeton, MO 63044-2512

Mailing address

1039 Rue la Ville Walk
Creve Coeur, MO 63141-6219
Phone (636) 448-4846

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

LicenseStateTypeSpecialty
2011036331MOMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1679822712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 RUE LA VILLE WALK",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416219",
            "telephone_number": "636-448-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442512",
            "telephone_number": "314-344-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUENSTEIN",
        "first_name": "BONNIE",
        "middle_name": "BETH",
        "credential": "R.D., L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2011036331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.