Department of Veterans Affairs

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

R422643

Legal business name

DEPARTMENT OF VETERANS AFFAIRS

Practice address

1500 East Woodrow Wilson Drive
Jackson, MS 39216-5199

Phone

(601) 362-4471

Fax

(601) 368-4483

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Laurie Smith, R.D. C.N.S.D.

Title

Clinical Dietitian

Phone

(601) 362-4471

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1730274887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EAST WOODROW WILSON DRIVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165199",
            "telephone_number": "601-362-4471",
            "fax_number": "601-368-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST WOODROW WILSON DRIVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165199",
            "telephone_number": "601-362-4471",
            "fax_number": "601-368-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CLINICAL DIETITIAN",
        "authorized_official_telephone_number": "601-362-4471",
        "authorized_official_credential": "R.D. C.N.S.D."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "R422643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Denton
• Julie Waddle Denton, MD
• Daniel Deornellas, PHARM.D.
• Stephanie Depaepe
• Department of Veterans Affair G.V. (Sonny) Montgomery VA Medical Cente
• Department of Veterans Affairs
• Dependable Source Corp. of Ms
• Dept. of Veteran Affairs
• Mattie Derivaux
• Dermatology Associates LLC

• Registered Dietitian in Jackson, MS
• Providers in Jackson, MS by specialty
• Registered Dietitian in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.