Active NPI
Tahirah Watley, MS, RD/LD
- Registered Dietitian
- Spencer, OK
National Provider Identifier
1700039419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1305
- Practice address
- 12716 NE 36TH St
Spencer, OK 73084-9167 - Phone
- (405) 769-3301
- Fax
- (405) 769-9685
- NPI assigned
- Oct 25, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 1305 | OK | Primary |
Addresses
Primary practice location
12716 NE 36TH St
Spencer, OK 73084-9167
Mailing address
PO Box 30589
Midwest City, OK 73140-3589
Phone (405) 769-3301
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": "1224892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236729600000",
"number": "1700039419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30589",
"city": "MIDWEST CITY",
"state": "OK",
"postal_code": "731403589",
"telephone_number": "405-769-3301",
"fax_number": "405-769-9685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12716 NE 36TH ST",
"city": "SPENCER",
"state": "OK",
"postal_code": "730849167",
"telephone_number": "405-769-3301",
"fax_number": "405-769-9685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATLEY",
"first_name": "TAHIRAH",
"credential": "MS, RD/LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-25",
"last_updated": "2009-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spencer, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.