Active NPI
Sara Namken, R.D.
- Registered Dietitian
- Decatur, IL
National Provider Identifier
1922418730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.004964
- Practice address
- 2122 N 27TH St
Decatur, IL 62526-2191 - Phone
- (217) 876-5292
- Fax
- (217) 876-5375
- NPI assigned
- May 1, 2014
- 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 | 164.004964 | IL | Primary |
Addresses
Primary practice location
2122 N 27TH St
Decatur, IL 62526-2191
Mailing address
2300 N Edward St
Gsbll
Decatur, IL 62526-4163
Phone (217) 876-2857
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
| License | State | Type | Specialty |
|---|---|---|---|
| 164.004964 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1922418730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 N EDWARD ST",
"address_2": "GSBLL",
"city": "DECATUR",
"state": "IL",
"postal_code": "625264163",
"telephone_number": "217-876-2857",
"fax_number": "217-876-2874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2122 N 27TH ST",
"city": "DECATUR",
"state": "IL",
"postal_code": "625262191",
"telephone_number": "217-876-5292",
"fax_number": "217-876-5375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAMKEN",
"first_name": "SARA",
"name_prefix": "Mrs.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-01",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.004964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.