Individual provider Active NPI

Meredith Pellegrini, RD

  • Registered Dietitian
  • Johnson City, TN
National Provider Identifier
1083178511
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86087850 Issued in TN
Practice address
2700 S Roan St Ste 410
Johnson City, TN 37601-7638
Phone
(423) 530-6556
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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 86087850 TN Primary

Addresses

Primary practice location

2700 S Roan St Ste 410
Johnson City, TN 37601-7638

Mailing address

3002 Moss Creek Dr
Johnson City, TN 37604-2274
Phone (423) 791-5016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200214000811 TN Practitioner - Registered Dietitian Or Nutrition Professional 5193151942 Reassigns benefits to 1 organization
I20201201002349 TX Practitioner - Registered Dietitian Or Nutrition Professional 5193151942 Reassigns benefits to 1 organization
I20211005001508 CA Practitioner - Registered Dietitian Or Nutrition Professional 5193151942 Practice locations: Palm Desert, CA

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practical Nutrition LLCGroup PAC ID 6406181395, 4 clinicians

Practice addresses (Care Compare)

2911 Medlin Dr
Arlington, TX 76015-2330
Phone (682) 564-2381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86087850TNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Practical Nutrition LLC Dietitian, Registered CurrentSince Sep 1, 2020 Accepting new patients
The Journey Center for Healing Arts, PLLC PastSince Jan 1, 2020 Accepting new patients
Sean a. Barlow, M.D. Past Accepting new patients

Locations

41990 Cook St
Ste 2008
Palm Desert, CA 92211
Phone (760) 674-9777

2911 Medlin Dr
Arlington, TX 76015
Phone (682) 564-2381

2005 NE Green Oaks Blvd
Ste 150
Arlington, TX 76006
Phone (817) 778-9157

4812 Roberts St
Greenville, TX 75401
Phone (903) 455-1234

555 Republic Dr
Plano, TX 75074
Phone (512) 693-1896

Organizations & group practices 4

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": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1083178511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 MOSS CREEK DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042274",
            "telephone_number": "423-791-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 S ROAN ST STE 410",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376017638",
            "telephone_number": "423-530-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINI",
        "first_name": "MEREDITH",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "86087850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.