Individual provider Active NPI

Behnjamin Ray Declue

  • Registered Dietitian
  • Saint Louis, MO
National Provider Identifier
1972429983
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2024039529 Issued in MO
Practice address
5447 Chippewa St Apt 6
Saint Louis, MO 63109-1642
Phone
(636) 697-0470
NPI assigned
Jun 24, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 2024039529 MO Primary

Addresses

Primary practice location

5447 Chippewa St Apt 6
Saint Louis, MO 63109-1642

Mailing address

5447 Chippewa St Apt 6
Saint Louis, MO 63109-1642

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

NPI Registry JSON

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

{
    "created_epoch": "1782259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1972429983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5447 CHIPPEWA ST APT 6",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5447 CHIPPEWA ST APT 6",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091642",
            "telephone_number": "636-697-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLUE",
        "first_name": "BEHNJAMIN",
        "middle_name": "RAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-24",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2024039529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.