Active NPI
Brooke Dianna Grubb, RD, LD
- Registered Dietitian
- Pine Bluff, AR
National Provider Identifier
1891248704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1519
- Practice address
- 1101 S Tennessee St
Pine Bluff, AR 71601-5801 - Phone
- (870) 543-2380
- NPI assigned
- Jul 27, 2016
- Last updated
- Jul 27, 2016
- 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 | 1519 | AR | Primary |
Addresses
Primary practice location
1101 S Tennessee St
Pine Bluff, AR 71601-5801
Mailing address
2400 Riverfront Dr
Apt 239
Little Rock, AR 72202-2208
Phone (573) 450-9625
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 |
|---|---|---|---|
| 1519 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469577600000",
"number": "1891248704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 RIVERFRONT DR",
"address_2": "APT 239",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722022208",
"telephone_number": "573-450-9625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 S TENNESSEE ST",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716015801",
"telephone_number": "870-543-2380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBB",
"first_name": "BROOKE",
"middle_name": "DIANNA",
"name_prefix": "Miss",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-27",
"last_updated": "2016-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "1519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.