Individual provider Active NPI

Gena Crenshaw, MS, RD, LD

  • Registered Dietitian
  • Ponca City, OK
National Provider Identifier
1689807257
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1662 Issued in OK
Practice address
1900 N 14TH St
Ponca City, OK 74601-2035
Phone
(580) 765-0269
Fax
(580) 718-2904
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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 1662 OK Primary

Addresses

Primary practice location

1900 N 14TH St
Ponca City, OK 74601-2035

Mailing address

1900 N 14TH St
Ponca City, OK 74601-2035
Phone (580) 765-0269

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

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1689807257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 N 14TH ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012035",
            "telephone_number": "580-765-0269",
            "fax_number": "580-718-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N 14TH ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012035",
            "telephone_number": "580-765-0269",
            "fax_number": "580-718-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "GENA",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.