Individual provider Active NPI

Judy Lee-Norris, R.D.

  • Registered Dietitian
  • Prescott, AZ
National Provider Identifier
1881618262
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
811748 Issued in AZ
Practice address
1090 Commerce Dr
Prescott, AZ 86305-3700
Phone
(928) 771-3122
Fax
(928) 771-3369
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 811748 AZ Primary

Addresses

Primary practice location

1090 Commerce Dr
Prescott, AZ 86305-3700

Mailing address

1090 Commerce Dr
Prescott, AZ 86305-3700
Phone (928) 771-3122

Other identifiers 1

IdentifierTypeStateIssuer
756009MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100302000637 TX Practitioner - Registered Dietitian Or Nutrition Professional 9931104627 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix Area Current Accepting new patients
DHHS IHS Phoenix Area CurrentSince Nov 17, 2017 Accepting new patients
Ton Santa Rosa Health Center Past Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Ton Sells Hospital Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881618262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 COMMERCE DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053700",
            "telephone_number": "928-771-3122",
            "fax_number": "928-771-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 COMMERCE DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053700",
            "telephone_number": "928-771-3122",
            "fax_number": "928-771-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-NORRIS",
        "first_name": "JUDY",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "811748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "756009",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.