Active NPI
Tammy Bradford Pennington, RD, CSR, LDN
- Registered Dietitian
- Monroe, LA
National Provider Identifier
1699967471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 578
- Practice address
- 711 Wood St
Monroe, LA 71201-7549 - Phone
- (318) 323-8847
- NPI assigned
- Aug 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 578 | LA | Primary |
Addresses
Primary practice location
711 Wood St
Monroe, LA 71201-7549
Mailing address
175 Comanche TRL
West Monroe, LA 71291-8105
Phone (318) 396-9293
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 578 | LA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187136000000",
"number": "1699967471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 COMANCHE TRL",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712918105",
"telephone_number": "318-396-9293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 WOOD ST",
"city": "MONROE",
"state": "LA",
"postal_code": "712017549",
"telephone_number": "318-323-8847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON",
"first_name": "TAMMY",
"middle_name": "BRADFORD",
"name_prefix": "Mrs.",
"credential": "RD, CSR, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-15",
"last_updated": "2007-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
- Latora Pegross
- Pelican Mobile Health, LLC
- Aristoteles Pena-Miches, M.D.
- Rosalind Aulette Penegar
- Patricia Pennington, FNPC
- People United of Louisiana LLC (People United of Louisiana)
- People United of Louisiana LLC
- People United of Louisiana LLC (People United Behavioral Health)
- People United of Louisiana LLC (People United of Louisiana)
- People United of Louisiana LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.