Individual provider Active NPI

Cheryl M Mitchell, RDN

  • Registered Dietitian
  • Dacula, GA
National Provider Identifier
1053474767
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD003307 Issued in GA
Practice address
1862 Auburn Rd Ste 118-Q5
Dacula, GA 30019-1676
Phone
(770) 744-1995
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X LD003307 GA Primary
Health Educator 174H00000X

Addresses

Primary practice location

1862 Auburn Rd Ste 118-Q5
Dacula, GA 30019-1676

Mailing address

PO Box 1715
Buford, GA 30515-8715
Phone (770) 744-1995

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
LD003307GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Living Renewed, Inc. Dietitian, Registered CurrentSince Oct 13, 2024 Accepting new patients

Locations

2550 Hamilton Mill Rd
Ste 13
Buford, GA 30519

1862 Auburn Rd
Ste 118
Dacula, GA 30019
Phone (678) 960-8953

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1053474767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1715",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305158715",
            "telephone_number": "770-744-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1862 AUBURN RD STE 118-Q5",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191676",
            "telephone_number": "770-744-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CHERYL",
        "middle_name": "M",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD003307",
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.