Lana Tom, MS, RD, CDN, LD
Dietitian, Registered in Saint Johns, FL. Individual provider (NPI-1).
NPI number1962010884
StatusActive
Last updated in NPPESDec 20, 2023
Details
- NPI
- 1962010884
- Entity type
- Individual (NPI-1)
- Name
- Lana Tom
- Credential
- MS, RD, CDN, LD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 16, 2020
- Certification date
- Dec 20, 2023
- Last updated
- Dec 20, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
Practice location
281 Pine Haven DrSaint Johns, FL 32259-7403
Phone 347-682-0387
Mailing address
281 Pine Haven DrSaint Johns, FL 32259-7403
Other practice locations
619 S Marion Ave
Lake City, FL 32025-5808
Lake City, FL 32025-5808
Phone 386-755-3016
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Registered Dietitian providers in Saint Johns, FL
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