Organization Active NPI

Desert Dietitians LLC

  • Registered Dietitian
  • Henderson, NV
National Provider Identifier
1942787122
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
DESERT DIETITIANS LLC
Practice address
2470 W Horizon Ridge Pkwy Ste 120
Henderson, NV 89052-2733
Phone
(608) 206-4837
NPI assigned
Jul 20, 2018
Last updated
Apr 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Stephanie Ingenito
Title
Credentialing Specialists
Phone
(570) 352-3063

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

2470 W Horizon Ridge Pkwy Ste 120
Henderson, NV 89052-2733

Mailing address

7073 Leadville Peak Ave
Las Vegas, NV 89179-1503
Phone (608) 206-4837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180806001130 NV Part B Supplier - Clinic/Group Practice 6507114642 Receives reassigned benefits from 3 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2470 W Horizon Ridge Pkwy
Ste 120
Henderson, NV 89052
Phone (608) 206-4837

8560 S Eastern Ave
Ste 100
Las Vegas, NV 89123
Phone (608) 206-4837

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1942787122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7073 LEADVILLE PEAK AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891791503",
            "telephone_number": "608-206-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 W HORIZON RIDGE PKWY STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522733",
            "telephone_number": "608-206-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT DIETITIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "INGENITO",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALISTS",
        "authorized_official_telephone_number": "570-352-3063"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.