NPIMap

Individual provider Active NPI

Deidra Johnson, RD, CDE

  • Registered Dietitian
  • Dallas, TX
National Provider Identifier
1699017871
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT02928 Issued in TX
Practice address
3434 Swiss Ave
Suite 410
Dallas, TX 75204-6251
Phone
(214) 828-5010
Fax
(214) 828-5011
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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 DT02928 TX Primary

Addresses

Primary practice location

3434 Swiss Ave
Suite 410
Dallas, TX 75204-6251

Mailing address

3434 Swiss Ave
Suite 410
Dallas, TX 75204-6251
Phone (214) 828-5010

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical Consultants, PLLC Past Accepting new patients
Healthtexas-Med Provider Past Accepting new patients
Healthsource of Frisco LLC Past Accepting new patients
W.E.G. Health Corp. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1699017871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 SWISS AVE",
            "address_2": "SUITE 410",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046251",
            "telephone_number": "214-828-5010",
            "fax_number": "214-828-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 SWISS AVE",
            "address_2": "SUITE 410",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046251",
            "telephone_number": "214-828-5010",
            "fax_number": "214-828-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEIDRA",
        "credential": "RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT02928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.