Individual provider Active NPI

Deena Yeamans, RDN

  • Registered Dietitian
  • Boca Raton, FL
National Provider Identifier
1811240757
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
876124 Issued in FL
Practice address
21301 Powerline Rd Ste 107
Boca Raton, FL 33433-2389
Phone
(305) 256-5067
NPI assigned
Oct 16, 2012
Reactivated
Jan 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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 876124 FL Primary

Addresses

Primary practice location

21301 Powerline Rd Ste 107
Boca Raton, FL 33433-2389

Mailing address

7440 San Clemente PL
Boca Raton, FL 33433-1005
Phone (786) 763-0041

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

LicenseStateTypeSpecialty
876124FLMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1811240757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 SAN CLEMENTE PL",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334331005",
            "telephone_number": "786-763-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21301 POWERLINE RD STE 107",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334332389",
            "telephone_number": "305-256-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAMANS",
        "first_name": "DEENA",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "deactivation_date": "2015-12-17",
        "reactivation_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "876124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.

Verify at the official NPI Registry.