Active NPI
Season Marie Johnson, NTP
- Nutritionist
- Bend, OR
National Provider Identifier
1801517586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 1381
- Practice address
- 1877 NW Hill Point Dr
Bend, OR 97703-1473 - Phone
- (530) 859-3299
- NPI assigned
- Sep 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 1381 | WA | Primary |
Addresses
Primary practice location
1877 NW Hill Point Dr
Bend, OR 97703-1473
Mailing address
1877 NW Hill Point Dr
Bend, OR 97703-1473
Phone (530) 859-3299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1381 | WA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1801517586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1877 NW HILL POINT DR",
"city": "BEND",
"state": "OR",
"postal_code": "977031473",
"telephone_number": "530-859-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1877 NW HILL POINT DR",
"city": "BEND",
"state": "OR",
"postal_code": "977031473",
"telephone_number": "530-859-3299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SEASON",
"middle_name": "MARIE",
"credential": "NTP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-09",
"last_updated": "2022-09-09",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WA",
"license": "1381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.