Active NPI
Mindy Donovan, RDN, LN
- Registered Dietitian
- Chamberlain, SD
National Provider Identifier
1063989762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 0212
- Practice address
- 300 S Byron Blvd
Chamberlain, SD 57325-9741 - Phone
- (605) 234-7106
- NPI assigned
- Oct 31, 2018
- 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 | 0212 | SD | Primary |
Addresses
Primary practice location
300 S Byron Blvd
Chamberlain, SD 57325-9741
Mailing address
119 S Allcott St
Chamberlain, SD 57325-1757
Phone (605) 234-5048
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0212 | SD | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New 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": "1540944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1063989762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 S ALLCOTT ST",
"city": "CHAMBERLAIN",
"state": "SD",
"postal_code": "573251757",
"telephone_number": "605-234-5048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 S BYRON BLVD",
"city": "CHAMBERLAIN",
"state": "SD",
"postal_code": "573259741",
"telephone_number": "605-234-7106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOVAN",
"first_name": "MINDY",
"credential": "RDN, LN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-31",
"last_updated": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SD",
"license": "0212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chamberlain, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.