Active NPI
Andrea Lynn Bode Vann, MS RD LD
- Registered Dietitian
- Texarkana, TX
National Provider Identifier
1821328899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT80323
- Practice address
- 2600 Saint Michael Dr
Texarkana, TX 75503-5220 - Phone
- (903) 614-5322
- NPI assigned
- Jan 13, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT80323 | TX | Primary |
| Registered Dietitian | 133V00000X | 998 | AR |
Addresses
Primary practice location
2600 Saint Michael Dr
Texarkana, TX 75503-5220
Mailing address
2600 Saint Michael Dr
Texarkana, TX 75503-5220
Phone (903) 614-5322
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT80323 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263340800000",
"number": "1821328899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 SAINT MICHAEL DR",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755035220",
"telephone_number": "903-614-5322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 SAINT MICHAEL DR",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755035220",
"telephone_number": "903-614-5322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANN",
"first_name": "ANDREA LYNN",
"middle_name": "BODE",
"credential": "MS RD LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-13",
"last_updated": "2010-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT80323",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "998",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.