Individual provider Active NPI

Sara Bradley Porter, MS RD LD

  • Registered Dietitian
  • Decatur, GA
National Provider Identifier
1124811864
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD007123 Issued in GA
Practice address
2736 Laurel Ridge Dr
Decatur, GA 30033-2934
Phone
(251) 554-0242
NPI assigned
May 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2025

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 LD007123 GA Primary

Addresses

Primary practice location

2736 Laurel Ridge Dr
Decatur, GA 30033-2934

Mailing address

2736 Laurel Ridge Dr
Decatur, GA 30033-2934
Phone (251) 554-0242

Other names 1

  • Sara Bradley Sheckells Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LD007123GAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1124811864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2736 LAUREL RIDGE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332934",
            "telephone_number": "251-554-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 LAUREL RIDGE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332934",
            "telephone_number": "251-554-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "SARA",
        "middle_name": "BRADLEY",
        "credential": "MS RD LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD007123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "SHECKELLS",
            "middle_name": "BRADLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; 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.