Active NPI
Kathryn Elizabeth Melko, PHD, RD, CDE
- Registered Dietitian
- Jacksonville, FL
National Provider Identifier
1003171463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND7112
- Practice address
- 4203 Belfort Rd
Suite 302
Jacksonville, FL 32216-1409 - Phone
- (904) 450-6317
- NPI assigned
- Jul 11, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND7112 | FL | Primary |
Addresses
Primary practice location
4203 Belfort Rd
Suite 302
Jacksonville, FL 32216-1409
Mailing address
4203 Belfort Rd
Suite 302
Jacksonville, FL 32216-1409
Phone (904) 450-6317
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ND7112 | Other | FL | LICENSED NUTRITIONIST/DIETITIAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND7112 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489708800000",
"number": "1003171463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4203 BELFORT RD",
"address_2": "SUITE 302",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161409",
"telephone_number": "904-450-6317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4203 BELFORT RD",
"address_2": "SUITE 302",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161409",
"telephone_number": "904-450-6317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELKO",
"first_name": "KATHRYN",
"middle_name": "ELIZABETH",
"credential": "PHD, RD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-11",
"last_updated": "2017-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND7112",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED NUTRITIONIST/DIETITIAN",
"identifier": "ND7112",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.