MRS. PATRICIA K REDDICKS (NPI# 1245380476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245380476 |
| Entity Type | Individual |
| Full Name | MRS. PATRICIA K REDDICKS |
| Credential | R.D |
| Practice Address |
101 Civic Center Ln Lake Havasu City AZ 86403-5607 |
| Practice Telephone | 9288558185 |
| Mailing Telephone | 9288558185 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 523071 | AZ | Dietary & Nutritional Service Providers |
| Street Address |
101 CIVIC CENTER LN |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176233 | Pamela B. Reband | Anesthesiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2005-06-28 |
| 1659995652 | Alana Stern | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2020-06-04 |
| 1245702927 | Michael Barber | Registered Nurse | 101 Civic Center Ln, Lake Havasu City, AZ 86403 | 2018-12-19 |
| 1891276630 | Brian Andrew | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2018-08-28 |
| 1497264873 | Pinnacle Radiology Services | Radiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2017-09-28 |
| 1821516287 | Jaime Wasik | Nurse Practitioner | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2017-09-06 |
| 1144776055 | Paul Queior | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2016-08-30 |
| 1891146957 | Misty Maple | Nurse Practitioner | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2016-06-29 |
| 1316319460 | Sarah Fraser | Specialist/Technologist, Other | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2015-10-28 |
| 1780067280 | Samer Asem Haddad | Internal Medicine | 101 Civic Center Ln, Lake Havasu City, AZ 86403 | 2015-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| 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 |
|---|---|---|---|---|
| 1245281815 | Sherri Ann Mason | Dietitian, Registered | 2156 Mcculloch Blvd N, Suite 4a, Lake Havasu City, AZ 86403-6786 | 2006-05-16 |
| 1891155974 | Hrmc, LLC | Dietitian, Registered | 1851 Mesquite Ave, Suite 202, Lake Havasu City, AZ 86403-5677 | 2016-03-02 |
| 1871671818 | Havasu Regional Medical Center, LLC | Dietitian, Registered | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395497 | Emily Verebelyi | Dietitian, Registered | 7525 E Placita De La Poesia, Tucson, AZ 85750-7200 | 2020-11-01 |
| 1790385938 | Kylee Makenna Forden | Dietitian, Registered | 3800 E Lincoln Dr Unit 38, Phoenix, AZ 85018-1020 | 2020-10-27 |
| 1346849023 | Emmie Mae Olivas | Dietitian, Registered | 1126 N Melody Cir, Chandler, AZ 85225-1695 | 2020-10-22 |
| 1699373985 | Ke Luo | Dietitian, Registered | 8771 N Ash Grove Ct, Tucson, AZ 85742-1411 | 2020-10-09 |
| 1740897859 | Gabrielle Dunlavey | Dietitian, Registered | 7950 E Starlight Way Unit 144, Scottsdale, AZ 85250-6133 | 2020-09-24 |
| 1558977538 | Michelle Hathaway | Dietitian, Registered | 10752 N 89th Pl Ste 114b, Scottsdale, AZ 85260-6730 | 2020-09-16 |
| 1770194615 | Lauren Ashley Duda | Dietitian, Registered | 5917 E Kings Ave, Scottsdale, AZ 85254-1318 | 2020-08-13 |
| 1407467343 | Emily Claire Pelham | Dietitian, Registered | 16601 N 12th St Apt 2051, Phoenix, AZ 85022-7720 | 2020-08-13 |
| 1225648827 | Kelly Michelle Clarken | Dietitian, Registered | 3220 W Ina Rd Apt 4202, Tucson, AZ 85741-2164 | 2020-08-07 |
| 1528678232 | Jodi Roark Charvoz | Dietitian, Registered | 5202 E 4th St, Tucson, AZ 85711-2302 | 2020-08-06 |
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| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
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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.