Individual provider Active NPI

Caitlyn Schull

  • Registered Dietitian
  • Tucson, AZ
National Provider Identifier
1780061853
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86009009 Issued in AZ
Practice address
3402 E Broadway Blvd
Tucson, AZ 85716-5406
Phone
(520) 405-9687
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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 86009009 AZ Primary

Addresses

Primary practice location

3402 E Broadway Blvd
Tucson, AZ 85716-5406

Mailing address

3402 E Broadway Blvd
Tucson, AZ 85716-5406

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160627001826 AZ Practitioner - Registered Dietitian Or Nutrition Professional 6901197615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86009009AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
El Con Health & Wellness Center LLC Dietitian, Registered CurrentSince May 7, 2016 Accepting new patients

Locations

3402 E Broadway Blvd
Tucson, AZ 85716
Phone (480) 498-8948

Organizations & group practices 1

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": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1780061853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165406",
            "telephone_number": "520-405-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULL",
        "first_name": "CAITLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86009009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; 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.