Mia Theresa Isaac-Mercer, NDTR

Primary specialty

Registered Dietetic TechnicianTaxonomy code 136A00000X

License

897242 Issued in VA

Practice address

311 Ridgeview Dr
Newport News, VA 23608-1290

Phone

(786) 546-9909

NPI assigned

May 5, 2020

Last updated

May 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1144841750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 RIDGEVIEW DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236081290",
            "telephone_number": "786-546-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 RIDGEVIEW DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236081290",
            "telephone_number": "786-546-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAAC-MERCER",
        "first_name": "MIA",
        "middle_name": "THERESA",
        "credential": "NDTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "VA",
            "license": "897242",
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "VA",
            "license": "897242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietetic Technician in Newport News, VA
• Providers in Newport News, VA by specialty
• Registered Dietetic Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.