Individual provider Active NPI

Lana Tom, MS, RD, CDN, LD

  • Registered Dietitian
  • Saint Johns, FL
National Provider Identifier
1962010884
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
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

Updated by the provider on Dec 20, 2023

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 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.

Verify at the official NPI Registry.