Individual provider Active NPI

Miyanna Breaux, MS, RD, LD

  • Registered Dietitian
  • Humble, TX
National Provider Identifier
1154912749
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86147446 Issued in TX
Practice address
20719 Fox Hound LN
Humble, TX 77338-1461
Phone
(832) 656-0813
NPI assigned
Jan 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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 86147446 TX Primary

Addresses

Primary practice location

20719 Fox Hound LN
Humble, TX 77338-1461

Mailing address

20719 Fox Hound LN
Humble, TX 77338-1461
Phone (832) 656-0813

Other names 1

  • Miyanna Kirksey 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
86147446TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1154912749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20719 FOX HOUND LN",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773381461",
            "telephone_number": "832-656-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20719 FOX HOUND LN",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773381461",
            "telephone_number": "832-656-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAUX",
        "first_name": "MIYANNA",
        "credential": "MS, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86147446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIYANNA",
            "last_name": "KIRKSEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.