Organization Active NPI

Rd4U Inc

  • Registered Dietetic Technician
  • Jensen Beach, FL
National Provider Identifier
1770807455
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Dietetic TechnicianTaxonomy code 136A00000X
License
ND2293 Issued in FL
Legal business name
RD4U INC
Practice address
2329 NE 18TH CT
Jensen Beach, FL 34957-5125
Phone
(954) 292-5625
Fax
(772) 334-8781
NPI assigned
Mar 24, 2010
Last updated
Mar 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Authorized official

Name
Mr. Adam Keith Lax, RDNPI 1104071539
Title
President
Phone
(954) 292-5625

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietetic TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 136A00000X ND2293 FL Primary

Addresses

Primary practice location

2329 NE 18TH CT
Jensen Beach, FL 34957-5125

Mailing address

2329 NE 18TH CT
Jensen Beach, FL 34957-5125
Phone (954) 292-5625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100524000189 FL Part B Supplier - Clinic/Group Practice 9931238318 Receives reassigned benefits from 1 practitioner
Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

Locations

11301 Okeechobee Blvd
Ste 5A
Royal Palm Beach, FL 33411
Phone (561) 283-0384

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1770807455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 NE 18TH CT",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349575125",
            "telephone_number": "954-292-5625",
            "fax_number": "772-334-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2329 NE 18TH CT",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349575125",
            "telephone_number": "954-292-5625",
            "fax_number": "772-334-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RD4U INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "LAX",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-292-5625",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietetic Technician, Registered",
            "state": "FL",
            "license": "ND2293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jensen Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.