Individual provider Active NPI

Stephanie Greunke, RD

  • Registered Dietitian
  • San Diego, CA
National Provider Identifier
1831434240
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1008217 Issued in WI
Practice address
11828 Bernardo Plaza CT Ste 100
San Diego, CA 92128-2402
Phone
(760) 789-5138
NPI assigned
Dec 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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 1008217 WI Primary

Addresses

Primary practice location

11828 Bernardo Plaza CT Ste 100
San Diego, CA 92128-2402

Mailing address

130 Athena St
Encinitas, CA 92024-2025
Phone (920) 569-9955

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

LicenseStateTypeSpecialty
1008217WIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1831434240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ATHENA ST",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242025",
            "telephone_number": "920-569-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11828 BERNARDO PLAZA CT STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282402",
            "telephone_number": "760-789-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREUNKE",
        "first_name": "STEPHANIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1008217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.