Active NPI
Bonnie Green, RDN, RYT-200
- Registered Dietitian
- Livonia, MI
National Provider Identifier
1225652076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 17418 Country Club Dr
Livonia, MI 48152-4802 - Phone
- (734) 419-3549
- NPI assigned
- Jun 7, 2020
- Reactivated
- Mar 8, 2021
- Last updated
- Mar 8, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | |||
| Nutrition Education Nutritionist | 133NN1002X | |||
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
17418 Country Club Dr
Livonia, MI 48152-4802
Mailing address
PO Box 532071
Livonia, MI 48153-2071
Other practice location 1
32961 Middlebelt Rd
Farmington Hills, MI 48334-1729
Phone (248) 855-1540
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peaceful & Powerful Nutrition, LLC | Nutritionist | Current | 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, 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": "1591488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1225652076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 532071",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481532071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17418 COUNTRY CLUB DR",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481524802",
"telephone_number": "734-419-3549"
}
],
"practiceLocations": [
{
"address_1": "32961 Middlebelt Rd",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483341729",
"country_code": "US",
"telephone_number": "248-855-1540",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "BONNIE",
"credential": "RDN, RYT-200",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-07",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"deactivation_date": "2021-02-03",
"reactivation_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": null,
"license": null,
"primary": false
},
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"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 Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.