Individual provider Active NPI

Michelle Ann McMurtery, RD, CSR, LDN

  • Registered Dietitian
  • Lake Mary, FL
National Provider Identifier
1205133584
Registry record updated Jul 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND6335 Issued in FL
Practice address
172 E Lake Mary Ave
Lake Mary, FL 32746-3046
Phone
(808) 446-5018
NPI assigned
Feb 22, 2011
Last updated
Jul 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2020

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 ND6335 FL Primary

Addresses

Primary practice location

172 E Lake Mary Ave
Lake Mary, FL 32746-3046

Mailing address

172 E Lake Mary Ave
Lake Mary, FL 32746-3046
Phone (808) 446-5018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811001490 FL Practitioner - Registered Dietitian Or Nutrition Professional 8123054350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nutrition Specialists Group LLCGroup PAC ID 3476978370, 2 clinicians

Practice addresses (Care Compare)

172 E Lake Mary Ave
McMurtery Home Office
Lake Mary, FL 32746-3046
Phone (321) 234-4045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND6335FLMDRegistered Dietitian
1614MAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Specialists Group LLC Dietitian, Registered CurrentSince Jul 21, 2020 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

21 W Fee Ave
Ste C
Melbourne, FL 32901
Phone (321) 409-0256

Organizations & group practices 2

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": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593907200000",
    "number": "1205133584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 E LAKE MARY AVE",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463046",
            "telephone_number": "808-446-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 E LAKE MARY AVE",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463046",
            "telephone_number": "808-446-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMURTERY",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "credential": "RD, CSR, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-22",
        "last_updated": "2020-07-05",
        "certification_date": "2020-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND6335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2020; 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.