Individual provider Active NPI

Renee M Siegfried, RD

  • Registered Dietitian
  • Nogales, AZ
National Provider Identifier
1871333682
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
811754 Issued in AZ
Practice address
1852 N Mastick Way
Nogales, AZ 85621-1063
Phone
(520) 761-2128
Fax
(520) 281-1112
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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 811754 AZ Primary

Addresses

Primary practice location

1852 N Mastick Way
Nogales, AZ 85621-1063

Mailing address

825 N Grand Ave Ste 100
Nogales, AZ 85621-1061
Phone (520) 761-2128

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
811754AZMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1871333682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N GRAND AVE STE 100",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211061",
            "telephone_number": "520-761-2128",
            "fax_number": "520-281-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 N MASTICK WAY",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211063",
            "telephone_number": "520-761-2128",
            "fax_number": "520-281-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGFRIED",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "811754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nogales, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.