Active NPI
Lana Tom, MS, RD, CDN, LD
- Registered Dietitian
- Saint Johns, FL
National Provider Identifier
1962010884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 281 Pine Haven Dr
Saint Johns, FL 32259-7403 - Phone
- (347) 682-0387
- NPI assigned
- Jul 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
281 Pine Haven Dr
Saint Johns, FL 32259-7403
Mailing address
281 Pine Haven Dr
Saint Johns, FL 32259-7403
Other practice location 1
619 S Marion Ave
Lake City, FL 32025-5808
Phone (386) 755-3016 ext. 39212
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703030400000",
"number": "1962010884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "281 PINE HAVEN DR",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322597403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "281 PINE HAVEN DR",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322597403",
"telephone_number": "347-682-0387"
}
],
"practiceLocations": [
{
"address_1": "619 S Marion Ave",
"address_purpose": "LOCATION",
"city": "Lake City",
"state": "FL",
"postal_code": "320255808",
"country_code": "US",
"telephone_number": "386-755-3016 x39212",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TOM",
"first_name": "LANA",
"credential": "MS, RD, CDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-16",
"last_updated": "2023-12-20",
"certification_date": "2023-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Johns, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.