Stephanie Lynn Maxson, MS, RD, LD

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

DT80967 Issued in TX

Practice address

1935 Medical District Dr
Clinical Nutrition
Dallas, TX 75235-7701

Phone

(214) 456-5698

Fax

(214) 456-6287

NPI assigned

Oct 31, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225411200000",
    "number": "1851544068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6024 VICTOR ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752145602",
            "telephone_number": "214-604-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "CLINICAL NUTRITION",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-5698",
            "fax_number": "214-456-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXSON",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2008-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TX",
            "license": "DT80967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETITIAN",
            "identifier": "00983946",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DIETITIAN",
            "identifier": "DT80967",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maxhealth Group LLC
• Maxim Healthcare Services, Inc.
• Maxim Medical Supplies LLC
• Maxim Mossman DDS, PLLC
• Maximacare LLC
• Maxum Health Services Corp
• Maxum Health Services Corp
• Maxum Health Services Corp
• Kristen Annette Maxvill, PHARM.D., BCPS
• Autumn Maxwell

• Pediatric Nutrition Registered Dietitian in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Nutrition Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.