Active NPI
Laura L Self, RDN, LD
- Registered Dietitian
- Austin, TX
National Provider Identifier
1730670290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT81191
- Practice address
- 100 Navigator Dr
Austin, TX 78717-4938 - Phone
- (214) 415-7630
- NPI assigned
- May 21, 2018
- Last updated
- May 21, 2018
- 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 | DT81191 | TX | Primary |
Addresses
Primary practice location
100 Navigator Dr
Austin, TX 78717-4938
Mailing address
100 Navigator Dr
Austin, TX 78717-4938
Phone (214) 415-7630
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 |
|---|---|---|---|
| DT81191 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526860800000",
"number": "1730670290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 NAVIGATOR DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787174938",
"telephone_number": "214-415-7630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 NAVIGATOR DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787174938",
"telephone_number": "214-415-7630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELF",
"first_name": "LAURA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "RDN, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-21",
"last_updated": "2018-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT81191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
- Select Physical Therapy Texas Limited Partnership
- Select Physical Therapy Texas Limited Partnership
- Svetlana Selezneva
- Self Reflections Counseling Services PLLC
- David Self, PT, DPT
- Christa Elizabeth Seligman, AGNP
- Claire Randall Selinger, M.D.
- Scott Selinger, MD
- Ashley Carmen Sellechio, PA-C
- Christopher Lee Sellers, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.