NPIMap

Individual provider Active NPI

Andrea L Miller, MS, RD

  • Registered Dietitian
  • St Louis Park, MN
National Provider Identifier
1023387669
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1083363 Issued in MN
Practice address
3200 Inglewood Ave S Apt 132
St Louis Park, MN 55416-4168
Phone
(206) 619-7366
NPI assigned
Dec 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1083363 MN Primary
Registered Dietitian 133V00000X 1083363 WA

Addresses

Primary practice location

3200 Inglewood Ave S Apt 132
St Louis Park, MN 55416-4168

Mailing address

3200 Inglewood Ave S Apt 132
St Louis Park, MN 55416-4168
Phone (206) 619-7366

Other names 1

  • Andrea L Cornelius Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1083363WAMDRegistered Dietitian
1083363MNMDFoster Care Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Everfit Inc Dietitian, Registered Past Accepting new patients
Cloud Health Medical Group of California, P.C. Past Accepting new patients
Cloud Health Medical Group of New Jersey, P.C. Past Accepting new patients
Henry Ford Health Rochester Hospital Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1023387669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 INGLEWOOD AVE S APT 132",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164168",
            "telephone_number": "206-619-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 INGLEWOOD AVE S APT 132",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164168",
            "telephone_number": "206-619-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "MS, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-28",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "1083363",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "1083363",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "CORNELIUS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.