Individual provider Active NPI

Deannea Tanner, RD

  • Registered Dietitian
  • Nampa, ID
National Provider Identifier
1952795528
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D1302 Issued in ID
Practice address
9850 W St Lukes Dr
Nampa, ID 83687-7912
Phone
(208) 706-7050
Fax
(208) 706-7059
NPI assigned
Mar 23, 2015
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D1302 ID Primary

Addresses

Primary practice location

9850 W St Lukes Dr
Nampa, ID 83687-7912

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other names 1

  • Deannea Maerritt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250408002223 ID Practitioner - Registered Dietitian Or Nutrition Professional 4981128261 Reassigns benefits to 3 organizations
I20250725004251 OR Practitioner - Registered Dietitian Or Nutrition Professional 4981128261 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Feb 28, 2025 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc Current Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Feb 28, 2025 Accepting new patients
Real Food Lifestyle, LLC Dietitian, Registered Past Accepting new patients

Locations

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1952795528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 W ST LUKES DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836877912",
            "telephone_number": "208-706-7050",
            "fax_number": "208-706-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "DEANNEA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D1302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNEA",
            "last_name": "MAERRITT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.