Active NPI
Edita C Baltasar, MPH, RD, LD
- Registered Dietitian
- Yukon, OK
National Provider Identifier
1710034699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD 222
- Practice address
- 729 Hamlet Cir
Yukon, OK 73099-4401 - Phone
- (405) 826-2023
- Fax
- (405) 354-1073
- NPI assigned
- Jan 4, 2007
- 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 | LD 222 | OK | Primary |
Addresses
Primary practice location
729 Hamlet Cir
Yukon, OK 73099-4401
Mailing address
PO Box 850894
Yukon, OK 73085-0894
Phone (405) 826-2023
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD 222 | OK | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baltasar Enterprises Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710034699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 850894",
"city": "YUKON",
"state": "OK",
"postal_code": "730850894",
"telephone_number": "405-826-2023",
"fax_number": "405-354-1073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "729 HAMLET CIR",
"city": "YUKON",
"state": "OK",
"postal_code": "730994401",
"telephone_number": "405-826-2023",
"fax_number": "405-354-1073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALTASAR",
"first_name": "EDITA",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "MPH, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "LD 222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yukon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.