NPIMap

Individual provider Active NPI

Michele M Peters, MS, RDN

  • Registered Dietitian
  • Locust, NJ
National Provider Identifier
1124469572
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
47 Wigwam Rd
Locust, NJ 07760-2337
Phone
(732) 708-1811
NPI assigned
Jul 15, 2013
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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 NU Primary

Addresses

Primary practice location

47 Wigwam Rd
Locust, NJ 07760-2337

Mailing address

47 Wigwam Rd
Locust, NJ 07760
Phone (917) 601-6439

Other practice location 1

1904 Atlantic Ave
Manasquan, NJ 08736-1006
Phone (732) 223-2100 ext. 213

Other practice location 2

325 Maple Ave
Red Bank, NJ 07701-2104
Phone (732) 292-4462

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)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew 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
Wilson Physical Medicine LLC PastSince Sep 17, 2011 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1124469572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 WIGWAM RD",
            "city": "LOCUST",
            "state": "NJ",
            "postal_code": "07760",
            "telephone_number": "917-601-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 WIGWAM RD",
            "city": "LOCUST",
            "state": "NJ",
            "postal_code": "077602337",
            "telephone_number": "732-708-1811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1904 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Manasquan",
            "state": "NJ",
            "postal_code": "087361006",
            "country_code": "US",
            "telephone_number": "732-223-2100 x213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Red Bank",
            "state": "NJ",
            "postal_code": "077012104",
            "country_code": "US",
            "telephone_number": "732-292-4462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "MICHELE",
        "middle_name": "M",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.