Active NPI
Carla Rae Patterson, RD
- Registered Dietitian
- Plummer, ID
National Provider Identifier
1871713198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D496
- Practice address
- 1115 B Street
Plummer, ID 83851 - Phone
- (208) 686-1931
- NPI assigned
- Apr 27, 2007
- 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 | D496 | ID | Primary |
Addresses
Primary practice location
1115 B Street
Plummer, ID 83851
Mailing address
1495 W Starling Ave
Hayden, ID 83835-8818
Phone (208) 686-1931
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
| License | State | Type | Specialty |
|---|---|---|---|
| D496 | ID | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871713198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1495 W STARLING AVE",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838358818",
"telephone_number": "208-686-1931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 B STREET",
"city": "PLUMMER",
"state": "ID",
"postal_code": "83851",
"telephone_number": "208-686-1931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "CARLA",
"middle_name": "RAE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "D496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plummer, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.