NPIMap

Individual provider Active NPI

Diane Blair Morris, RDN, LD

  • Registered Dietitian
  • Fayetteville, GA
National Provider Identifier
1063089548
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD003256 Issued in GA
Practice address
160 Susan LN
Fayetteville, GA 30215-2056
Phone
(678) 389-1016
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X LD003256 GA Primary

Addresses

Primary practice location

160 Susan LN
Fayetteville, GA 30215-2056

Mailing address

160 Susan LN
Fayetteville, GA 30215-2056
Phone (678) 389-1016

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL Fayetteville Direct
CONNECT URL Fayetteville Direct
CONNECT URL Fayetteville Direct

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
LD003256GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

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": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1063089548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 SUSAN LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152056",
            "telephone_number": "678-389-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 SUSAN LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152056",
            "telephone_number": "678-389-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "DIANE",
        "middle_name": "BLAIR",
        "name_prefix": "Mrs.",
        "credential": "RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD003256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fayetteville",
            "affiliation": "N",
            "endpointDescription": "diane@dianebmorris.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "160 Susan Ln",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302152056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fayetteville",
            "affiliation": "N",
            "endpointDescription": "diane@dianebmorris.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "160 Susan Ln",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302152056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fayetteville",
            "affiliation": "N",
            "endpointDescription": "diane@dianebmorris.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "160 Susan Ln",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302152056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.