Individual provider Active NPI

Miranda G. Hayden, MPH,RD, CSR

  • Registered Dietitian
  • Newport News, VA
National Provider Identifier
1174730121
Registry record updated Apr 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
13195 Warwick Blvd Ste 2B
Newport News, VA 23602-8313
Phone
(757) 570-6588
Fax
(757) 534-7801
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

13195 Warwick Blvd Ste 2B
Newport News, VA 23602-8313

Mailing address

13195 Warwick Blvd Ste 2B
Newport News, VA 23602-8313
Phone (757) 570-6588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040612000680 VA Practitioner - Registered Dietitian Or Nutrition Professional 7810970480 Practice locations: Newport News, VA
I20190507003070 NC Practitioner - Registered Dietitian Or Nutrition Professional 7810970480 Practice locations: Fayetteville, NC

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13195 Warwick Blvd
Suite 2B
Newport News, VA 23602-8313
Phone (757) 570-6588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Therapy Works Nutrition, Renal Current Accepting new patients

Locations

13195 Warwick Blvd
Ste 2B
Newport News, VA 23602
Phone (757) 570-6588

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522540800000",
    "number": "1174730121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 WARWICK BLVD STE 2B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236028313",
            "telephone_number": "757-570-6588",
            "fax_number": "757-534-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 WARWICK BLVD STE 2B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236028313",
            "telephone_number": "757-570-6588",
            "fax_number": "757-534-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "MIRANDA",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "MPH,RD, CSR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.