Individual provider Active NPI

Gabrielle Dawn Taylor, R.D./L.D.

  • Registered Dietitian
  • Tulsa, OK
National Provider Identifier
1780605030
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1395 Issued in OK
Practice address
6655 S Yale Ave
Tulsa, OK 74136-3326
Phone
(918) 491-3700
Fax
(918) 481-4063
NPI assigned
Jul 22, 2006
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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 1395 OK Primary

Addresses

Primary practice location

6655 S Yale Ave
Tulsa, OK 74136-3326

Mailing address

PO Box 707001
Tulsa, OK 74170-7001
Phone (888) 247-0125

Other practice location 1

550 S Peoria Ave
Tulsa, OK 74120-3820
Phone (918) 588-1900

Other identifiers 1

IdentifierTypeStateIssuer
200678900AMedicaidOK

Other names 1

  • Miss Gabrielle Dawn Ketter Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050901000768 OK Practitioner - Registered Dietitian Or Nutrition Professional 7810933777 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1395OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Meals by Joleen LLC Dietitian, Registered Past Accepting new patients
Indian Health Care Resource Center of Tulsa, Inc. Past Accepting new patients
Therapeutic Connections PastSince Nov 22, 2016 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1780605030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707001",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741707001",
            "telephone_number": "888-247-0125",
            "fax_number": "918-502-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363326",
            "telephone_number": "918-491-3700",
            "fax_number": "918-481-4063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Peoria Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741203820",
            "country_code": "US",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "GABRIELLE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "R.D./L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200678900A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "KETTER",
            "middle_name": "DAWN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.