MRS. TANIA CYNARA DE SOUSA BEZERRA (NPI# 1316483779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316483779 |
| Entity Type | Individual |
| Full Name | MRS. TANIA CYNARA DE SOUSA BEZERRA |
| Credential | RDN |
| Practice Address |
310 Home Blvd Galesburg IL 61401-7408 |
| Practice Telephone | 3093430311 |
| Mailing Telephone | 3093430311 |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | 9034685-4901 | UT | Dietary & Nutritional Service Providers |
| N | 133V00000X | Dietitian, Registered | DN005188 | PA | Dietary & Nutritional Service Providers |
| Y | 133V00000X | Dietitian, Registered | 164006374 | IL | Dietary & Nutritional Service Providers |
| Street Address |
310 HOME BLVD |
| City | GALESBURG |
| State | IL |
| Zip Code | 61401-7408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962887604 | Dawn Michele Dominguez | Nurse Practitioner | 310 Home Blvd, Galesburg, IL 61401-7408 | 2015-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174973 | Jeff Engwall | Pharmacist | 359 Knox Square Drive, Galesburg, IL 61401 | 2020-11-03 |
| 1861962441 | Becky Cameron | Counselor | 2323 Windish Dr., Galesburg, IL 61401 | 2018-11-27 |
| 1295245496 | Aaron Thomas Wachtel | Dentist | 1172 Monroe Street, Galesburg, IL 61401 | 2017-10-03 |
| 1588182224 | Alicia Warren | Speech-Language Pathologist | 932 Harrison St., Galesburg, IL 61401 | 2017-09-01 |
| 1770986770 | Virginia G Kasser | Psychologist | 575 N Kellogg, Galesburg, IL 61401 | 2014-10-03 |
| 1063814309 | Lakshmi Kalyani Gudavalli | Physical Therapist | 275 E Carl Sandburg Drive, Marigold Rehabilitation, Galesburg, IL 61401 | 2014-09-18 |
| 1821350489 | James Eugene Tiller | Psychologist | 2101 Windish Drive, Galesburg, IL 61401 | 2012-06-11 |
| 1720285836 | Donald J. Regnier | Hearing Instrument Specialist | 4l Plaza, Suite 57, Galesburg, IL 61401 | 2007-07-02 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114140373 | Community Residential Centers Inc | Intermediate Care Facility, Mentally Retarded | 239 S Cherry Street, Galesburg, IL 61401 | 2007-04-10 |
| Find all providers in zip 61401 | ||||
| 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 |
|---|---|---|---|---|
| 1356723241 | Andrea Tenley | Dietitian, Registered | 546 Olive St, Galesburg, IL 61401-3462 | 2015-06-26 |
| 1760876007 | Lynn Bachelder | Dietitian, Registered | 1975 National Blvd, Galesburg, IL 61401-1488 | 2015-03-25 |
| 1588088777 | Stefanie Riley | Dietitian, Registered | 1975 National Blvd, Galesburg, IL 61401-1488 | 2014-02-10 |
| 1245653393 | Katrina Dianne Howard | Dietitian, Registered | 2030 E Main St, Galesburg, IL 61401-5460 | 2014-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366726 | Frankie O'brien | Dietitian, Registered | 2551 N Clark St Ste 400, Chicago, IL 60614-7725 | 2020-11-04 |
| 1841891207 | Elizabeth Kristin Julius | Dietitian, Registered | 833 W Buena Ave Apt 1901, Chicago, IL 60613-6634 | 2020-11-03 |
| 1417556747 | Jamie Anne Mayhew | Dietitian, Registered | 2917 W 99th Pl, Evergreen Park, IL 60805-2641 | 2020-10-19 |
| 1033716345 | Efthemia Greco | Dietitian, Registered | 9654 Kelley Ln, Huntley, IL 60142-0058 | 2020-10-08 |
| 1679170203 | Lotus Therapy Group Inc | Dietitian, Registered | 112 Kansas St, Frankfort, IL 60423-1447 | 2020-10-06 |
| 1447857065 | Tran Huynh | Dietitian, Registered | 6126 N Rockwell St Apt 3, Chicago, IL 60659-2859 | 2020-10-06 |
| 1033716113 | Ulani Villanueva | Dietitian, Registered | 470 Pfingsten Road, Northbrook, IL 60062-2506 | 2020-10-02 |
| 1780281873 | Alyssa Marie Post | Dietitian, Registered | 3512 Rollingridge Rd, Naperville, IL 60564-8298 | 2020-10-02 |
| 1285231324 | Megan Rhodes | Dietitian, Registered | 539 Willowcreek Ct, Clarendon Hills, IL 60514-1693 | 2020-10-01 |
| 1508473711 | Susan Faith Madnek-oxman | Dietitian, Registered | 1051 Wade St, Highland Park, IL 60035-4153 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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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.