Active NPI
Michelle Evangeline Dennison, LD
- Registered Dietitian
- Oklahoma City, OK
National Provider Identifier
1245209279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1193
- Practice address
- 4913 W Reno Ave
Oklahoma City, OK 73127-6339 - Phone
- (405) 948-4900
- NPI assigned
- Mar 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 1193 | OK | |
| Registered Dietitian | 133V00000X | 1193 | OK | Primary |
Addresses
Primary practice location
4913 W Reno Ave
Oklahoma City, OK 73127-6339
Mailing address
4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone (405) 948-4900
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1245209279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4913 W RENO AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731276339",
"telephone_number": "405-948-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4913 W RENO AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731276339",
"telephone_number": "405-948-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNISON",
"first_name": "MICHELLE",
"middle_name": "EVANGELINE",
"credential": "LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-14",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "OK",
"license": "1193",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.