ELLEN SURATT STANBACK RD,LD,CLC
NPI 1780768663
Dietitian, Registered in Lithonia, GA

Q: What is Ellen Stanback's NPI number?

The NPI number for Ellen Stanback is 1780768663. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Q: What is Ellen Stanback's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ellen Stanback was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since October 25, 2006

2277 STONE MOUNTAIN LITHONIA RD, LITHONIA, GA 30058(770) 484-2600(770) 484-3830 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Ellen Suratt Stanback Rd,ld,clc NPPES

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

ELLEN SURATT STANBACK RD,LD,CLC (NPI 1780768663) is an individual dietitian, registered in Lithonia, Georgia, licensed in Georgia (LD001907) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1780768663

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameELLEN SURATT STANBACKCredential: RD,LD,CLC

Location Address2277 STONE MOUNTAIN LITHONIA RDLithonia, GA 30058-5252

Mailing Address3177 Kensington RdAvondale Estates, GA 30002-1457 · (404) 299-1150

Phone(770) 484-2600

Fax(770) 484-3830

Sole ProprietorNo

Enumeration DateOctober 25, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1780768663 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 GA · LD001907

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.

2277 STONE MOUNTAIN LITHONIA RD, Lithonia, GA 30058

Open in Google Maps ↗

Other Identifiers 2

Medicare UPINQ06385GA

Medicare ID-Type Unspecified71BBMKGA

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AYANNA TENAY HARRIS LPN

Licensed Practical Nurse