Active NPI
Stephanie Sall, MA, RD, LD
- Registered Dietitian
- Brandon, FL
National Provider Identifier
1851055644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND10692
- Practice address
- 1735 Wakefield Dr
Brandon, FL 33511-2313 - Phone
- (315) 420-0488
- NPI assigned
- Oct 27, 2021
- 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 | ND10692 | FL | Primary |
Addresses
Primary practice location
1735 Wakefield Dr
Brandon, FL 33511-2313
Mailing address
1735 Wakefield Dr
Brandon, FL 33511-2313
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND10692 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1851055644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1735 WAKEFIELD DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335112313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1735 WAKEFIELD DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335112313",
"telephone_number": "315-420-0488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALL",
"first_name": "STEPHANIE",
"credential": "MA, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-27",
"last_updated": "2021-10-27",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND10692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.