Active NPI
Stephanie Ticer
- Registered Dietitian
- Fort Belvoir, VA
National Provider Identifier
1689124521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 9300 Dewitt Loop
Fort Belvoir, VA 22060-5285 - Phone
- (571) 231-3224
- NPI assigned
- Oct 4, 2016
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Mailing address
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689124521 | Medicaid | WA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563148800000",
"number": "1689124521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9300 DEWITT LOOP",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "220605285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 DEWITT LOOP",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "220605285",
"telephone_number": "571-231-3224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TICER",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-04",
"last_updated": "2019-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689124521",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Belvoir, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.