MR. LARRY WILLIAM IMMENSCHUH (NPI# 1699914168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699914168 |
| Entity Type | Individual |
| Full Name | MR. LARRY WILLIAM IMMENSCHUH |
| Credential | RDLD |
| Practice Address |
3009 N. W. Wilson Street Fort Sill OK 73503-9042 |
| Mailing Address |
1406 Ne Independence Ave Lawton OK 73507-3438 |
| Practice Telephone | 5804582134 |
| Practice Fax Number | 5804582314 |
| Mailing Telephone | 5806953213 |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2019-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 630 | OK | Dietary & Nutritional Service Providers |
| Street Address |
3009 N. W. WILSON STREET |
| City | FORT SILL |
| State | OK |
| Zip Code | 73503-9042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824446 | Alex Boyd | Dentist | U.S.A. Dental Health Activity, 652 Hamilton Road, Fort Sill, OK 73503 | 2020-06-01 |
| 1588145031 | Dustin Davis | Dentist | Usa Dental Health Activity 652 Hamilton Rd., Fort Sill, OK 73503 | 2018-08-23 |
| 1578086492 | Austin Kent Brown | Dentist | Usa Dental Activity 652 Hamilton Rd., Fort Sill, OK 73503 | 2017-07-23 |
| 1083155998 | Michael Gagliano | Physician Assistant | 4301 Wilson Street, Attn: Mcua-qm Credentials, Reynolds Army Health Clinic, Fort Sill, OK 73503 | 2017-03-10 |
| 1619428885 | Kristi Ann Putnam | Registered Nurse | Sgt Bleak Troop Medical Clinic, 6039 Berry Street, Fort Sill, OK 73503 | 2016-10-21 |
| 1003265901 | Lucy Muller | Registered Nurse | 4301 Wilson Road, Ft Sill, OK 73503 | 2016-06-10 |
| 1356740146 | Gregory B Kiene | Dentist | 642 Hamilton Rd, Usa Dental Activity, Fort Sill, OK 73503 | 2014-08-18 |
| 1295152262 | Cheryl Marie Wildman | Dental Assistant | 2640 Miner Road, Weeks Dental Clinic, Ft Sill, OK 73503 | 2014-03-27 |
| 1245664143 | Tina L Gray | Dentist | 652 Hamilton Road, Suite 210, Fort Sill Dentac, Fort Sill, OK 73503 | 2013-08-27 |
| 1720410533 | Katherine Loi | Dentist | 652 Hamilton Rd, Fort Sill Dentac, Suite 210, Fort Sill, OK 73503 | 2013-08-02 |
| Find all providers in zip 73503 | ||||
| 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 |
|---|---|---|---|---|
| 1467607739 | Kendra Leigh Piasecki | Dietitian, Registered | 807 Nw Rehn Rd, Fort Sill, OK 73503-4522 | 2008-11-29 |
| 1689851628 | Brenda D Bustillos | Dietitian, Registered | 4301 Mow-way Road (mcua-ncd), Cdr Usameddac, Fort Sill, OK 73503-6300 | 2008-01-22 |
| 1932452810 | Beatriz George | Dietitian, Registered | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2012-10-17 |
| 1629152863 | Amy Rae See | Dietitian, Registered | 4301 Mow-way Road, Fort Sill, OK 73503 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912506411 | Candance Elaine Gabel | Dietitian, Registered | 220 S 2nd Ct, Stillwater, OK 74074-6732 | 2020-10-26 |
| 1326646852 | Lori Mathews | Dietitian, Registered | 2821 36th Ave Nw Ste 150, Norman, OK 73072-2472 | 2020-10-16 |
| 1437756947 | Malorie Scherf | Dietitian, Registered | 8751 N 97th East Ave Apt 917, Owasso, OK 74055-6887 | 2020-10-07 |
| 1154928216 | Shaina Sara Yohannan | Dietitian, Registered | 9028 Nw 84th St, Yukon, OK 73099-8677 | 2020-10-01 |
| 1598370066 | Laci N Patterson | Dietitian, Registered | 9401 Prosper Dr, Oklahoma City, OK 73151-8811 | 2020-09-11 |
| 1619586534 | Amanda Kate Tucker | Dietitian, Registered | 312 12th Ave Ne, Norman, OK 73071-5238 | 2020-07-27 |
| 1154939452 | Cornerstone Nutrition & Diabetes, Pllc | Dietitian, Registered | 2500 Boardwalk Ste 220, Norman, OK 73069-6593 | 2020-07-22 |
| 1558989335 | Angelica Martinez De Loera | Dietitian, Registered | 7761 Alameda St, Norman, OK 73026-3738 | 2020-07-08 |
| 1326665548 | Olivia Jean Trout | Dietitian, Registered | 4311 Se 57th St, Oklahoma City, OK 73135-3308 | 2020-07-03 |
| 1447875471 | Nicholas A Koemel | Dietitian, Registered | 3724 W 32nd Ave, Stillwater, OK 74074-1724 | 2020-06-16 |
| 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.