Individual provider Active NPI

Michelle Thomas Brown, RD

  • Registered Dietitian
  • Moncks Corner, SC
National Provider Identifier
1053938795
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1982 Issued in SC
Practice address
3508 S Live Oak Dr
Moncks Corner, SC 29461-8737
Phone
(843) 958-2590
Fax
(843) 606-7996
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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 1982 SC Primary

Addresses

Primary practice location

3508 S Live Oak Dr
Moncks Corner, SC 29461-8737

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Other identifiers 1

IdentifierTypeStateIssuer
DT1193MedicaidSC

Other names 1

  • Michelle T. Grossman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715000756 SC Practitioner - Registered Dietitian Or Nutrition Professional 7618390279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2093 Henry Tecklenburg Dr
202E
Charleston, SC 29414-5783
Phone (843) 958-2590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1982SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Jul 20, 2020 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jul 20, 2020 Accepting new patients
Roper St. Francis Specialty Physicians CurrentSince Feb 1, 2026 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients
Cloud Health Medical Group of New Jersey, P.C. Past Accepting new patients
Cloud Health Medical Group of California, P.C. Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Locations

2093 Henry Tecklenburg Dr
Ste 202E
Charleston, SC 29414
Phone (843) 720-5665

2093 Henry Tecklenburg Dr
#202E
Charleston, SC 29414
Phone (843) 720-5665

2093 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1006

2097 Henry Tecklenburg Dr
Ste 211W
Charleston, SC 29414
Phone (843) 958-2555

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

3508 S Live Oak Dr
Moncks Corner, SC 29461
Phone (843) 534-1770

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

300 Callen Blvd
Ste 330
Summerville, SC 29486
Phone (843) 577-7550

Organizations & group practices 8

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": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1053938795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 S LIVE OAK DR",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294618737",
            "telephone_number": "843-958-2590",
            "fax_number": "843-606-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHELLE",
        "middle_name": "THOMAS",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "1982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DT1193",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "GROSSMAN",
            "middle_name": "T.",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.