Active NPI
Ann Lois Fladie, R.D., L.D.
- Registered Dietitian
- Tahlequah, OK
National Provider Identifier
1811092729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 637
- Practice address
- 1400 E Downing St
Tahlequah, OK 74464-3324 - Phone
- (918) 453-2266
- Fax
- (918) 453-2196
- NPI assigned
- Sep 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 637 | OK | Primary |
Addresses
Primary practice location
1400 E Downing St
Tahlequah, OK 74464-3324
Mailing address
102 Agni Way
Tahlequah, OK 74464-9200
Phone (918) 456-6277
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 647795 | Other | OK | DIETETIC REGISTRATION |
| 637 | Other | OK | MEDICAL LICENSURE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 637 | OK | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811092729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 AGNI WAY",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744649200",
"telephone_number": "918-456-6277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E DOWNING ST",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744643324",
"telephone_number": "918-453-2266",
"fax_number": "918-453-2196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLADIE",
"first_name": "ANN",
"middle_name": "LOIS",
"credential": "R.D., L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIETETIC REGISTRATION",
"identifier": "647795",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSURE",
"identifier": "637",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.