Marcia Fastabend Pell, RD, LD/N, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND 3263 Issued in FL

Practice address

2337 Judson St
Lynn Haven, FL 32444-3018

Phone

(850) 867-0336

NPI assigned

Jan 9, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Marcia Fastabend Lipscomb Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1700023959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2337 JUDSON ST",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443018",
            "telephone_number": "850-867-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2337 JUDSON ST",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443018",
            "telephone_number": "850-867-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELL",
        "first_name": "MARCIA",
        "middle_name": "FASTABEND",
        "credential": "RD, LD/N, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND 3263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIA",
            "last_name": "LIPSCOMB",
            "middle_name": "FASTABEND",
            "credential": "RD, LD/N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brigget Oswald, LMT
• Larry O Otwell, AUD CCCA
• Panama Internal Medicine Associates
• Panama Internal Medicine Associates
• Pediatrics Plus, Inc.
• Morgan Paige Peterson
• Eric Justin Pettitt, CRNA
• Brandi Lynn Phinazee, FNP-C
• David Pierce, D.O.
• Jerrett C Pigott, PHARM D.

• Registered Dietitian in Lynn Haven, FL
• Providers in Lynn Haven, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.