Active NPI
Stephanie Dyan Tarver, LDN,RD
- Registered Dietitian
- Shreveport, LA
National Provider Identifier
1972859973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 832710
- Practice address
- 1035 Creswell Ave
Shreveport, LA 71101-3917 - Phone
- (318) 676-5159
- NPI assigned
- Jul 27, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 1313 | LA | |
| Registered Dietitian | 133V00000X | 832710 | LA | Primary |
Addresses
Primary practice location
1035 Creswell Ave
Shreveport, LA 71101-3917
Mailing address
1525 Fairfield Ave
RM. 569
Shreveport, LA 71101-4300
Phone (318) 676-7473
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1313 | LA | MD | Nutrition Education Nutritionist |
| 832710 | LA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343347200000",
"number": "1972859973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 FAIRFIELD AVE",
"address_2": "RM. 569",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711014300",
"telephone_number": "318-676-7473",
"fax_number": "318-676-7560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 CRESWELL AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711013917",
"telephone_number": "318-676-5159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARVER",
"first_name": "STEPHANIE",
"middle_name": "DYAN",
"name_prefix": "Ms.",
"credential": "LDN,RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-27",
"last_updated": "2012-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "LA",
"license": "1313",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "832710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.