Individual provider Active NPI

Nana Rushka Stark, MS, RD

  • Registered Dietitian
  • Los Angeles, CA
National Provider Identifier
1902231749
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1060823 Issued in CA
Practice address
538 N. Mansfield Avenue
Los Angeles, CA 90036-2612
Phone
(323) 717-7346
NPI assigned
Sep 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dietary Manager 132700000X 1060823 CA
Nutrition Education Nutritionist 133NN1002X 1060823
Registered Dietitian 133V00000X 1060823 CA Primary
Pediatric Nutrition Registered Dietitian 133VN1004X 1060823
Renal Nutrition Registered Dietitian 133VN1005X 1060823
Metabolic Nutrition Registered Dietitian 133VN1006X 1060823 CA

Addresses

Primary practice location

538 N. Mansfield Avenue
Los Angeles, CA 90036-2612

Mailing address

538 N Mansfield Ave
Los Angeles, CA 90036-2012
Phone (323) 717-7346

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1060823CAMDDietary Manager

NPI Registry JSON

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1902231749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 N MANSFIELD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362012",
            "telephone_number": "323-717-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 N. MANSFIELD AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362612",
            "telephone_number": "323-717-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "NANA",
        "middle_name": "RUSHKA",
        "name_prefix": "Ms.",
        "credential": "MS, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "132700000X",
            "taxonomy_group": "",
            "desc": "Dietary Manager",
            "state": "CA",
            "license": "1060823",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": "1060823",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1060823",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": "1060823",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": "1060823",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "CA",
            "license": "1060823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.