Active NPI
Kelly Golladay, RD
- Registered Dietitian
- Novi, MI
National Provider Identifier
1043783483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86038838
- Practice address
- 39475 Lewis Dr Ste 110
Novi, MI 48377-2977 - Phone
- (989) 277-5784
- NPI assigned
- Jan 8, 2019
- 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 | 86038838 | Primary |
Addresses
Primary practice location
39475 Lewis Dr Ste 110
Novi, MI 48377-2977
Mailing address
39475 Lewis Dr Ste 110
Novi, MI 48377-2977
Other names 1
- Kelly Osika
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546905600000",
"number": "1043783483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39475 LEWIS DR STE 110",
"city": "NOVI",
"state": "MI",
"postal_code": "483772977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39475 LEWIS DR STE 110",
"city": "NOVI",
"state": "MI",
"postal_code": "483772977",
"telephone_number": "989-277-5784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLLADAY",
"first_name": "KELLY",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-08",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86038838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "OSIKA",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.