MS. MARILYN L SAMPLE (NPI# 1720304710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720304710 |
| Entity Type | Individual |
| Full Name | MS. MARILYN L SAMPLE |
| Other Name | MISS MARILYN L HAAVISTO |
| Credential | RD |
| Practice Address |
483 W. Seed Farm Rd Sacaton AZ 85147-0115 |
| Mailing Address |
483 W. Seed Farm Rd. Sacaton AZ 85147-0115 |
| Practice Telephone | 6022581340 |
| Practice Fax Number | 6025281296 |
| Mailing Telephone | 6025281340 |
| Mailing Fax Number | 6025281296 |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2010-04-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 685690 | IL | Dietary & Nutritional Service Providers |
| Street Address |
483 W. SEED FARM RD |
| City | SACATON |
| State | AZ |
| Zip Code | 85147-0115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124006630 | Kenneth R Geans | Social Worker | 483 W. Seed Farm Rd, Sacaton, AZ 85247 | 2006-01-04 |
| 1003327685 | Robert William Adams | Registered Nurse | 483 W. Seed Farm Rd, Sacaton, AZ 85147 | 2017-10-23 |
| 1730583725 | Ronald M Fosson | Dietitian, Registered | 483 W. Seed Farm Rd, Gila River Health Care Corporation, Sacaton, AZ 85147-0038 | 2014-10-20 |
| 1528304755 | Cynthia Ann Carter | Nurse Practitioner | 483 W. Seed Farm Rd, Sacaton, AZ 85147 | 2012-12-16 |
| 1720335003 | Dean Fasciani | Optometrist | 483 W. Seed Farm Rd, Sacaton, AZ 85147-0038 | 2012-08-06 |
| 1497020804 | Becky Gail Brundin | Dietitian, Registered | 483 W. Seed Farm Rd, Sacaton, AZ 85147-0038 | 2012-03-19 |
| 1497034342 | Shannon Yvonne Borrego | Optometrist | 483 W. Seed Farm Rd, Sacaton, AZ 85147 | 2011-08-10 |
| 1720371396 | Crystal Amber Kunka | Family Medicine | 483 W. Seed Farm Rd, Sacaton, AZ 85147 | 2011-05-16 |
| 1124323621 | Melissa R Lill | Nurse Practitioner | 483 W. Seed Farm Rd, Sacaton, AZ 85147 | 2011-01-14 |
| 1538478946 | Stacy Marie Crow | Physical Therapist | 483 W. Seed Farm Rd, Sacaton, AZ 85147 | 2010-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104452507 | Jeremy James Pumphrey | Counselor | 438 W Seed Farm Rd, Sacaton, AZ 85147 | 2020-03-17 |
| 1215563804 | Leo Oswaldo Merino | Counselor | 291 W. Casa Blanca Rd. Bldg. # 7, Sacaton, AZ 85147 | 2020-03-16 |
| 1588166896 | Stephanie Lashawn Brown | Social Worker | 483 West Seed Farm Rd., Sacaton, AZ 85147 | 2018-03-02 |
| 1255602447 | Joyce Mildred Villalobos | Counselor | Gila River Health Care Corp, 483 W Seed Farm Rd, Sacaton, AZ 85147 | 2012-01-19 |
| 1417237074 | Gila River Health Care | Community/Behavioral Health | 291 W Casa Blanca Rd, Sacaton, AZ 85147 | 2011-08-26 |
| 1750598322 | Kari Beth Harris | Social Worker | 198 South Skill Center Road, Sacaton, AZ 85147 | 2007-05-16 |
| 1740378694 | Vincent Anthony Berkley | Internal Medicine | 198 S. Skill Center Road, Sacaton, AZ 85147 | 2006-10-10 |
| 1568448801 | Wesley Neil Yamada | Podiatrist | 483 W Seed Farm Road, Sacaton, AZ 85147 | 2005-12-19 |
| 1376532515 | Frances Antone | Physician Assistant | 483 W Seed Farm Rd., Sacaton, AZ 85147 | 2005-10-20 |
| 1538167051 | Xuong Wilkinson | Family Medicine | 483 West Seed Farm Road, Sacaton, AZ 85147 | 2005-07-08 |
| Find all providers in zip 85147 | ||||
| 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 |
|---|---|---|---|---|
| 1477038222 | Rachel Lynn Pfeifer | Dietitian, Registered | 483 W Seed Farm Rd, Sacaton, AZ 85147 | 2018-09-27 |
| 1598257248 | Corinne C Ciuris | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85043 | 2018-05-30 |
| 1346791571 | Emily Perkins | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2016-10-24 |
| 1861852329 | Christine Waite | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2016-02-26 |
| 1033583109 | Maili Huck Carey | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2015-11-30 |
| 1730583725 | Ronald M Fosson | Dietitian, Registered | 483 W. Seed Farm Rd, Gila River Health Care Corporation, Sacaton, AZ 85147-0038 | 2014-10-20 |
| 1346681962 | Katherine N Dougherty | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2013-07-11 |
| 1164861258 | Annalise C. Wood | Dietitian, Registered | 483 W. Seed Farm Rd., Huhukam Memorial Hospital, Sacaton, AZ 85147-0038 | 2013-06-21 |
| 1316205214 | Melva L. Zerkoune | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2012-04-27 |
| 1497020804 | Becky Gail Brundin | Dietitian, Registered | 483 W. Seed Farm Rd, Sacaton, AZ 85147-0038 | 2012-03-19 |
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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.