Active NPI
Nancy Ann Ullrey, R.D.
- Registered Dietitian
- Grand Rapids, MI
National Provider Identifier
1154769941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- R410665
- Practice address
- 3596 Tricklewood Dr SE
Grand Rapids, MI 49546-7246 - Phone
- (616) 949-2732
- NPI assigned
- Jun 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | R410665 | IN | Primary |
Addresses
Primary practice location
3596 Tricklewood Dr SE
Grand Rapids, MI 49546-7246
Mailing address
3596 Tricklewood Dr SE
Grand Rapids, MI 49546-7246
Phone (616) 949-2732
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R410665 | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371081600000",
"number": "1154769941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3596 TRICKLEWOOD DR SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467246",
"telephone_number": "616-949-2732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3596 TRICKLEWOOD DR SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467246",
"telephone_number": "616-949-2732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ULLREY",
"first_name": "NANCY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-13",
"last_updated": "2013-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "R410665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.