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FALLON BADER MS, RDN, LD
NPI 1407616949
Dietitian, Registered in Jemez Pueblo, NM

Active since March 21, 2024
139 BEAR HEAD CANYON RD UNIT B, JEMEZ PUEBLO, NM 87024(908) 670-2348 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Fallon Bader Ms, Rdn, Ld NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FALLON BADER MS, RDN, LD (NPI 1407616949) is an individual dietitian, registered in Jemez Pueblo, New Mexico, licensed in New Mexico (NDP-2024-0036) and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1407616949
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameFALLON BADERCredential: MS, RDN, LD
Location Address139 BEAR HEAD CANYON RD UNIT BJemez Pueblo, NM 87024-0776
Mailing Address31 Cedar Hill Pl NeAlbuquerque, NM 87122-1906
Phone(908) 670-2348
Sole ProprietorNo
Enumeration DateMarch 21, 2024
NPPES CertifiedMarch 21, 2024
✔ NPI 1407616949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in NM · NDP-2024-0036
Definition
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.
139 BEAR HEAD CANYON RD UNIT B, Jemez Pueblo, NM 87024
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fallon Bader Ms, Rdn, Ld is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Fallon Bader reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pueblo Of Jemez
1.3 mi
Clinic/Center
110 SHEEP SPRINGS WAY
Jemez Pueblo, NM 87024
  • Reassigned Medicare billing, Texas enrollment
  • 38 clinicians in this Medicare group
NPI 1417082215 (575) 834-7413

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fallon Bader's NPI number?

The NPI number for Fallon Bader is 1407616949. It was assigned to this individual provider in the NPPES registry on March 21, 2024.

Where is Fallon Bader located?

Fallon Bader practices at 139 Bear Head Canyon Rd Unit B, Jemez Pueblo, NM 87024. The listed phone number is (908) 670-2348.

What is Fallon Bader's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Fallon Bader enrolled in Medicare?

Yes. Fallon Bader is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Fallon Bader's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Fallon Bader reassigns Medicare benefits to Pueblo Of Jemez (Jemez Pueblo, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Fallon Bader's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Fallon Bader was last updated on March 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.