Active NPI
Therese Picasso-Edwards, RD
- Registered Dietitian
- Red Lodge, MT
National Provider Identifier
1992917686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 495
- Practice address
- 600 W 21St St
Red Lodge, MT 59068 - Phone
- (406) 446-2345
- NPI assigned
- May 4, 2007
- Last updated
- Jul 8, 2007
- 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 | 495 | MT | Primary |
Addresses
Primary practice location
600 W 21St St
Red Lodge, MT 59068
Mailing address
2 Snowy LN.
Red Lodge, MT 59068-9645
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070809000250 | MT | Practitioner - Registered Dietitian Or Nutrition Professional | 6901997659 | Practice locations: Red Lodge, MT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 495 | MT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Picasso Health & Nutrition | Dietitian, Registered | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992917686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 SNOWY LN.",
"city": "RED LODGE",
"state": "MT",
"postal_code": "590689645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 W 21ST ST",
"city": "RED LODGE",
"state": "MT",
"postal_code": "59068",
"telephone_number": "406-446-2345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICASSO-EDWARDS",
"first_name": "THERESE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MT",
"license": "495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Lodge, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.