Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1538550132 Individual Practitioner Female Practitioner

Stephanie Lynn Thomas , RD, CD

Dietitian, Registered • Peoria, IL

Professional Overview & Biography Verified Profile Summary

Stephanie Thomas, RD, CD is a registered healthcare professional specializing in Dietitian, Registered in Peoria, IL. Practice services are available at 530 NE GLEN OAK AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

530 Ne Glen Oak Ave

Peoria, IL 616373201

Telephone 3096249844
Associated Practice Facility / Clinic
🏢 University Of Illinois Facility NPI 1255301909

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.0 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
65 Specialists

Practicing in Peoria, IL (2895 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-07-19
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License IL 164009191

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Dietitian, Registered

NUCC Taxonomy Code: 133V00000X

State License IN 37002483A

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Medicare Ptan
IN3131008 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Heather Boore , APN, CNS-BC

Clinical Nurse Specialist - Pediatrics

NPI 1083062285

Advanced Practice Nurse, CNSBC

Dr. Blas Zelaya , MD

Pediatrics - Neurodevelopmental Disabilities

NPI 1295704468

Doctor of Medicine (M.D.)

Dr. Mark Jennings , MD

Neuromusculoskeletal Medicine & OMM

NPI 1356315246

Doctor of Medicine (M.D.)

Diana Warnecke , APN, CPNP

Nurse Practitioner - Pediatrics

NPI 1396183687

Advanced Practice Nurse, Certified Pediatric Nurse Practitioner

Dr. Mark Miller , MD

Pediatrics - Pediatric Endocrinology

NPI 1528359106

Doctor of Medicine (M.D.)

Dr. Nizar Kherallah , MD

Pediatrics - Pediatric Pulmonology

NPI 1669467726

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location July 19, 2023

Registered at 530 NE GLEN OAK AVE, PEORIA, IL 616373201 (Tel: 3096249844)

📍
Updated Business Mailing Address July 19, 2023

Registered at 302 ELGIN CT, WASHINGTON, IL 615711143 (Tel: 2192410234)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2023

Dietitian, Registered (License #164009191 in IL)

NPI Profile Active June 20, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 20, 2017

Registered at 1007 LINCOLNWAY, LA PORTE, IN 463503201 (Tel: 2193257632)

📍
Updated Business Mailing Address June 20, 2017

Registered at 1007 LINCOLNWAY, LA PORTE, IN 463503201 (Tel: 2193257632)

👤
Provider Name / Credentials Updated June 20, 2017

Recorded as STEPHANIE THOMAS, RD, CD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2017

Dietitian, Registered (License #37002483A in IN)

NPI Profile Active February 18, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location February 18, 2015

Registered at 1007 LINCOLNWAY, LA PORTE, IN 463503201 (Tel: 2193257632)

📍
Updated Business Mailing Address February 18, 2015

Registered at 1007 LINCOLNWAY, LA PORTE, IN 463503201 (Tel: 2193257632)

👤
Provider Name / Credentials Updated February 18, 2015

Recorded as STEPHANIE MAHAN, RD, CD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 18, 2015

Dietitian, Registered (License #37002483A in IN)

🟢
Initial NPI Registration & Enumeration February 18, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1538550132
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 18, 2015
Last Update: July 19, 2023
Sole Proprietor: No

Mailing Address

302 Elgin Ct

Washington, IL 615711143

Phone: 2192410234

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.