Individual provider Active NPI

Melissa Ann Thomas, RDN, LD, CLC

  • Registered Dietitian
  • Snellville, GA
National Provider Identifier
1013579242
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86009986 Issued in GA
Practice address
1600 Medical Way Ste 100
Snellville, GA 30078-2159
Phone
(770) 736-2354
NPI assigned
Jul 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86009986 GA Primary

Addresses

Primary practice location

1600 Medical Way Ste 100
Snellville, GA 30078-2159

Mailing address

1600 Medical Way Ste 100
Snellville, GA 30078-2159
Phone (770) 736-2354

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86009986GAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1013579242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL WAY STE 100",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782159",
            "telephone_number": "770-736-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL WAY STE 100",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782159",
            "telephone_number": "770-736-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "RDN, LD, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "86009986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.