Alexandra Georgiadis, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86021201 Issued in MI

Practice address

4410 Arapahoe Ave Ste 110
Boulder, CO 80303-1135

Phone

(720) 315-0051

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Serenity Therapeutic Counseling & Addiction Services LLC

  • Clinical Social Worker
  • Clinton Township, MI
  • NPI 1225810666
  Medicare reassignment NPD
• Essential Nutrition LLC

  • Clinic/Center
  • Boulder, CO
  • NPI 1104043553

  Dietitian, Registered

  NPD
• JD Counseling

  • Community Health Clinic/Center
  • Livonia, MI
  • NPI 1346919198
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1114585015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W GRAND RIVER AVE STE A",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641604",
            "telephone_number": "248-479-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 ARAPAHOE AVE STE 110",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031135",
            "telephone_number": "720-315-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGIADIS",
        "first_name": "ALEXANDRA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "86021201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Geoffrion, MA
• George a Garry
• George Ray Russell MD PC
• Aliyah George
• Elizabeth L. George, PH.D.
• Gerald B Savory DDS PC
• Gerald Chitters MD PLLC
• Michele L. Gerard, PH.D.
• Daniel J Gerber, M.D.
• Zachary Gergely

• Registered Dietitian in Boulder, CO
• Providers in Boulder, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.