STACI DIANE HENDRICKSON (NPI# 1295064574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295064574 |
| Entity Type | Individual |
| Full Name | STACI DIANE HENDRICKSON |
| Credential | RD |
| Practice Address |
4930 Overland Dr Lawrence KS 66049-4132 |
| Mailing Address |
734 N 1851st Diag Rd Lecompton KS 66050-4114 |
| Practice Telephone | 7857604501 |
| Practice Fax Number | 7857271805 |
| Mailing Telephone | 7857604501 |
| Mailing Fax Number | 7857271805 |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2015-05-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 000947 | KS | Dietary & Nutritional Service Providers |
| Street Address |
4930 OVERLAND DR |
| City | LAWRENCE |
| State | KS |
| Zip Code | 66049-4132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497718357 | Heather E Yates | Family Medicine | 4930 Overland Dr, Lawrence, KS 66049-4132 | 2006-04-10 |
| 1184273286 | Madison Ashlee Scott | Physician Assistant | 4930 Overland Dr, Lawrence, KS 66049-4132 | 2019-09-11 |
| 1215400775 | Advanced Medical Imaging, LLC | Radiology | 4930 Overland Dr, Lawrence, KS 66049-4132 | 2019-01-08 |
| 1407367097 | Leslie Lindsay | Physician Assistant | 4930 Overland Dr, Lawrence, KS 66049-4132 | 2017-10-23 |
| 1093264871 | Kimberly Byler | Nurse Practitioner | 4930 Overland Dr, Lawrence, KS 66049-4132 | 2016-09-22 |
| 1982032926 | Breah Chambers | Nurse Practitioner | 4930 Overland Dr, Lawrence, KS 66049-4132 | 2013-10-30 |
| 1831467729 | Jennifer A Strickland | Nurse Practitioner | 4930 Overland Dr, Lawrence, KS 66049-4132 | 2011-12-06 |
| 1861636961 | Elizabeth Ann Beal | Family Medicine | 4930 Overland Dr, Lawrence, KS 66049 | 2009-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724481 | Mt Oread Pharmacy LLC | Pharmacy | 6265 Rock Chalk Drive, Lmh Health West, Suite 1401, Lawrence, KS 66049 | 2020-06-10 |
| 1497382204 | Limestone Eye Care LLC | Optometrist | 4320 W 6th Street, Suite 103, Lawrence, KS 66049 | 2020-03-24 |
| 1053840405 | Garrett Greaves | Physical Therapist | 100 Rock Chalk Lane, Suite 100, Lawrence, KS 66049 | 2017-06-08 |
| 1164971875 | Nicholas Salava | Dentist | 5100 Bob Billings Pkwy Ste 110, Lawrence, KS 66049 | 2016-09-23 |
| 1992163273 | Katherine Kershner | Physical Therapy Assistant | 11311 Wakarusa Dr Ste 1000, Lawrence, KS 66049 | 2016-02-02 |
| 1740670603 | Mary Cabib Tawadros | Family Medicine | 5911 Longleaf Dr., Lawrence, KS 66049 | 2015-01-30 |
| 1972872943 | Jean Alan Sanders | Pathology | 2820 Tomahawk Drive, Lawrence, KS 66049 | 2011-12-21 |
| 1881975563 | Vicki Annette Condra-williams | Counselor | 1123 Stone Meadows Drive, Lawrence, KS 66049 | 2011-09-08 |
| 1225328768 | Mark W Smith | Counselor | 2619 W. 6th St, Suite C, Lawrence, KS 66049 | 2011-04-18 |
| 1164739173 | Laura Elizabeth Reischman | Physical Therapy Assistant | 1305 Wakarusa Drive, Lawrence, KS 66049 | 2010-09-13 |
| Find all providers in zip 66049 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174168629 | Sarah Miller | Dietitian, Registered | 21 Auerbach Ln, Lawrence, NY 11559-2529 | 2019-11-07 |
| 1851892848 | Leigh Croteau Hartwell | Dietitian, Registered | 280 Merrimack St Ste 400, Lawrence, MA 01843-1787 | 2018-02-23 |
| 1962800383 | Sarah Atwood | Dietitian, Registered | 25 Marston St Ste 204, Lawrence, MA 01841-2310 | 2014-12-17 |
| 1134376569 | Shifra Eisig | Dietitian, Registered | 43 Herrick Drive, Lawrence, NY 11559 | 2008-08-27 |
| 1801079116 | Heather Fiore | Dietitian, Registered | 2721 W 6th St Ste F, Lawrence, KS 66049-4306 | 2007-12-10 |
| 1205950698 | Teresa Danyela Weis-schupak | Dietitian, Registered | 375 Broadway, Lawrence, NY 11559-1805 | 2007-03-19 |
| 1003942533 | Jean M Lussier | Dietitian, Registered | 34 Haverhill Street, Lawrence, MA 01841 | 2007-02-26 |
| 1003877101 | Mandi Joy Madowicz | Dietitian, Registered | 22 Waverly Pl, Lawrence, NY 11559-2513 | 2006-03-29 |
| 1154942605 | Angela Meyer | Dietitian, Registered | 2415 Massachusetts St, Lawrence, KS 66046-4827 | 2020-05-06 |
| 1780243493 | Mandy Peers-greaves | Dietitian, Registered | 325 Maine St, Lawrence, KS 66044-1360 | 2019-06-07 |
| Find all providers in LAWRENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.