Individual provider Active NPI

Mikayla Milady Anderson, RD, MS, CDN

  • Registered Dietitian
  • Lagrangeville, NY
National Provider Identifier
1194573832
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
011881-01 Issued in NY
Practice address
1131 State Route 55
Lagrangeville, NY 12540-5054
Phone
(845) 489-3020
NPI assigned
May 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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 011881-01 NY Primary

Addresses

Primary practice location

1131 State Route 55
Lagrangeville, NY 12540-5054

Mailing address

1131 State Route 55
Lagrangeville, NY 12540-5054
Phone (203) 794-4183

Other practice location 1

670 Stoneleigh Ave
Carmel, NY 10512-3997
Phone (475) 237-1023

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
011881-01NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1194573832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 STATE ROUTE 55",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405054",
            "telephone_number": "203-794-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 STATE ROUTE 55",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405054",
            "telephone_number": "845-489-3020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "670 Stoneleigh Ave",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "NY",
            "postal_code": "105123997",
            "country_code": "US",
            "telephone_number": "475-237-1023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MIKAYLA",
        "middle_name": "MILADY",
        "credential": "RD, MS, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "011881-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrangeville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.