Individual provider Active NPI

Stephanie Hacker, RD

  • Registered Dietitian
  • Miami, FL
National Provider Identifier
1750780797
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND6705 Issued in FL
Practice address
1400 NW 12TH Ave
Miami, FL 33136-1003
Phone
(305) 243-6006
Fax
(305) 243-3919
NPI assigned
Aug 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND6705 FL Primary

Addresses

Primary practice location

1400 NW 12TH Ave
Miami, FL 33136-1003

Mailing address

1400 NW 12TH Ave
Miami, FL 33136-1003
Phone (305) 243-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140910000678 FL Practitioner - Registered Dietitian Or Nutrition Professional 3375762115 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND6705FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1601 NW 12th Ave
Ste 6001
Miami, FL 33136
Phone (305) 243-6006

1400 NW 12th Ave
Miami, FL 33136
Phone (305) 325-5416

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

8932 SW 97th Ave
Miami, FL 33176
Phone (305) 270-3485

Organizations & group practices 2

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": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1750780797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "305-243-6006",
            "fax_number": "305-243-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "305-243-6006",
            "fax_number": "305-243-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKER",
        "first_name": "STEPHANIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND6705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.