Individual provider Active NPI

Alicia Glass, RD

  • Sports Dietetics Nutrition Registered Dietitian
  • Marietta, GA
National Provider Identifier
1174433056
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X
License
LD005449 Issued in GA
Practice address
4708 Green River CT NE
Marietta, GA 30068-4869
Phone
(719) 338-5528
NPI assigned
Sep 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered Dietitian 133VN1501X LD005449 GA Primary

Addresses

Primary practice location

4708 Green River CT NE
Marietta, GA 30068-4869

Mailing address

4708 Green River CT NE
Marietta, GA 30068-4869
Phone (719) 338-5528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1174433056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 GREEN RIVER CT NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684869",
            "telephone_number": "719-338-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 GREEN RIVER CT NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684869",
            "telephone_number": "719-338-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "ALICIA",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "GA",
            "license": "LD005449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.