MISS DESSIREA KNOX (NPI# 1720685852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720685852 |
| Entity Type | Individual |
| Full Name | MISS DESSIREA KNOX |
| Credential | NDTR |
| Practice Address |
224 S Chestnut Ave Moore OK 73160-5223 |
| Mailing Address |
2413 Kings Rd Moore OK 73160-1137 |
| Practice Telephone | 4057590853 |
| Mailing Telephone | 5804819270 |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 136A00000X | Dietetic Technician, Registered | 86264698 | OK | Dietary & Nutritional Service Providers |
| Street Address |
224 S CHESTNUT AVE |
| City | MOORE |
| State | OK |
| Zip Code | 73160-5223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689224453 | Krystin Lorg I | Pharmacist | 224 S Chestnut Ave, Moore, OK 73160-5223 | 2019-09-13 |
| 1942810197 | Kristin Holetzky | Family Medicine | 224 S Chestnut Ave, Moore, OK 73160-5223 | 2020-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| Taxonomy Code | 136A00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietetic Technician, Registered |
| A person trained in food and nutrition who is an integral part of health care and foodservice management teams. A dietetic technician, registered (DTR) has successfully completed at least a two-year associate’s degree at a US regionally accredited college or university; a dietetic technician program approved by The American Dietetic Association, including 450 hours of supervised practice experience; 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 Dietetic Technician, Registered -- a food and nutrition practitioner. Chicago, IL: The American dietetic association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750923637 | Tanya R Humphrey | Dietetic Technician, Registered | 12 Buffalo Pl, Burneyville, OK 73430-2136 | 2019-10-12 |
| 1508078726 | Patsy Ann Kates | Dietetic Technician, Registered | 20122 North Tamaha Road, Stigler, OK 74462 | 2007-05-03 |
| 1043841893 | Cody Werneburg | Dietetic Technician, Registered | 3300 Healthplex Pkwy, Norman, OK 73072-9749 | 2020-01-30 |
| 1083069009 | Erin Endress | Dietetic Technician, Registered | 3712 E 11th St, Tulsa, OK 74112-3952 | 2016-04-27 |
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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.