Individual provider Active NPI

Laurie A Malyar, RD

  • Registered Dietitian
  • Mountain Home, TN
National Provider Identifier
1689632465
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
0000000898 Issued in TN
Practice address
James H. Quillen Vamc
Nutrition and Food Services 120
Mountain Home, TN 37684
Phone
(423) 926-1171
Fax
(423) 979-3402
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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 0000000898 TN Primary

Addresses

Primary practice location

James H. Quillen Vamc
Nutrition and Food Services 120
Mountain Home, TN 37684

Mailing address

4096 Greenwood Dr
Jonesborough, TN 37659-6251
Phone (423) 753-5854

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
0000000898TNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1689632465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4096 GREENWOOD DR",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376596251",
            "telephone_number": "423-753-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JAMES H. QUILLEN VAMC",
            "address_2": "NUTRITION AND FOOD SERVICES 120",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALYAR",
        "first_name": "LAURIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "0000000898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.