Individual provider Active NPI

Julie Reiss, RD

  • Registered Dietitian
  • Pueblo, CO
National Provider Identifier
1932302957
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone
(719) 557-5374
Fax
(719) 557-4100
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 917568 CO
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

1008 Minnequa Ave
Pueblo, CO 81004-3733

Mailing address

1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone (719) 557-7374

Other identifiers 1

IdentifierTypeStateIssuer
917568OtherCODIETICIAN

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

LicenseStateTypeSpecialty
917568COMDRehabilitation Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1932302957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043733",
            "telephone_number": "719-557-7374",
            "fax_number": "719-557-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043733",
            "telephone_number": "719-557-5374",
            "fax_number": "719-557-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISS",
        "first_name": "JULIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CO",
            "license": "917568",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETICIAN",
            "identifier": "917568",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.