Simone Gillingham, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LDD10153903 Issued in OR

Practice address

8495 Crater Lake Hwy
Mail Stop 10
White City, OR 97503-3011

Phone

(541) 826-2111

NPI assigned

Aug 8, 2014

Last updated

Aug 8, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Simone Champagne Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1942619465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 ALAMEDA ST APT 15",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8495 CRATER LAKE HWY",
            "address_2": "MAIL STOP 10",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975033011",
            "telephone_number": "541-826-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLINGHAM",
        "first_name": "SIMONE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LDD10153903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIMONE",
            "last_name": "CHAMPAGNE",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn Y. Germain, LCSW
• Benjamin Lee Giesbrecht, PSY.D.
• Ethel Lynne Giesbrecht, LPN
• Nicole Gifford
• Francis Stanley Gilbert, PH.D.
• Ashley Taylor Glazener, PHARMD
• Jaimie Terra Good, RN
• Goode Family Dental LLC
• Michael Garrett Goode, DDS
• Victor Collins Gordon, RN

• Registered Dietitian in White City, OR
• Providers in White City, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.

Verify at the official NPI Registry.