Alyssa Strom

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD005012 Issued in GA

Practice address

3025 Breckinridge Blvd Ste 160
Duluth, GA 30096-8985

Phone

(678) 447-6637

NPI assigned

May 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1770104747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 STATION CIR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714560",
            "telephone_number": "678-447-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 BRECKINRIDGE BLVD STE 160",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968985",
            "telephone_number": "678-447-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROM",
        "first_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD005012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD STATE LICENSE",
            "identifier": "LD005012",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cpr+",
            "affiliation": "N",
            "endpointDescription": "electronic note system",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "phone conversation",
            "address_1": "3025 Breckinridge Blvd Ste 160",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300968985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon M Stone Hare, RBT
• Donna M Stone, D.D.S.
• Grace Melanie Stone
• Shannon Straughan
• John H Strickler Jr., MD MBA
• Whitney Stroup, DPT
• Atiya Stubbs
• Austin Kevin Su, DPT
• Alicia Viviana Suarez
• Subi Healthcare Services LLC

• Registered Dietitian in Duluth, GA
• Providers in Duluth, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; 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.