NPIMap

Organization Active NPI

Four County Nutrition, Inc

  • Registered Dietitian
  • Mount Airy, MD
National Provider Identifier
1851567705
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D01409 Issued in MD
Legal business name
FOUR COUNTY NUTRITION, INC
Practice address
1104 Village Oaks Dr
Mount Airy, MD 21771-5378
Phone
(240) 215-5084
NPI assigned
May 1, 2008
Last updated
Oct 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Authorized official

Name
Tracey Stamates Roerty, RD
Title
Owner
Phone
(240) 215-5084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D01409 MD Primary

Addresses

Primary practice location

1104 Village Oaks Dr
Mount Airy, MD 21771-5378

Mailing address

1104 Village Oaks Dr
Mount Airy, MD 21771-5378
Phone (240) 215-5084

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1851567705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 VILLAGE OAKS DR",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715378",
            "telephone_number": "240-215-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 VILLAGE OAKS DR",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715378",
            "telephone_number": "240-215-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR COUNTY NUTRITION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "ROERTY",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "STAMATES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-215-5084",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "D01409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.