Active NPI
Melissa Stockwell, RDN
- Registered Dietitian
- Gainesville, FL
National Provider Identifier
1215702923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND10928
- Practice address
- 4120 NW 37TH PL Apt 204
Gainesville, FL 32606-7040 - Phone
- (352) 757-7724
- NPI assigned
- Nov 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND10928 | FL | Primary |
Addresses
Primary practice location
4120 NW 37TH PL Apt 204
Gainesville, FL 32606-7040
Mailing address
9200 NW 39TH Ave Ste 130-56
Gainesville, FL 32606-7331
Phone (352) 757-7724
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND10928 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New 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": "1700611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700611200000",
"number": "1215702923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 NW 39TH AVE STE 130-56",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326067331",
"telephone_number": "352-757-7724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4120 NW 37TH PL APT 204",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326067040",
"telephone_number": "352-757-7724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOCKWELL",
"first_name": "MELISSA",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-22",
"last_updated": "2023-11-22",
"certification_date": "2023-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND10928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.