Lydia Ballenger
Individual provider Active NPI Registered Dietitian · Indianapolis, IN
NPI 1982178463 · NPPES record last updated Jan 17, 2019
Key facts
- NPI
- 1982178463
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 37001780A (IN)
- Practice address
- 566 Ironridge CT
Indianapolis, IN 46239-8890 - Phone
- (765) 506-0376
- NPI assigned
- Jan 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37001780A | IN | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | 37001780A | IN | Yes |
Addresses
Primary practice location
566 Ironridge CT
Indianapolis, IN 46239-8890
Mailing address
566 Ironridge CT
Indianapolis, IN 46239-8890
Phone (765) 506-0376
Other providers in Indianapolis, IN
- Shelby Lauren Ballard
- Tessa Ballard
- Victoria Elizabeth Ballard
- Eric Alexander Balle
- Jo Ellen Ballenger
- Paulina Ballesteros
- Kevin Ballew
- Jessica Ballinger
- Latasha Ballinger
- Susan R Ballinger
All providers in Indianapolis, IN · Registered Dietitian in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.