Active NPI
Humaira Mohiuddin, RD
- Registered Dietitian
- Dyer, IN
National Provider Identifier
1255690160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37001676A
- Practice address
- 1208 Flagstone Dr
Dyer, IN 46311-2290 - Phone
- (219) 440-2708
- NPI assigned
- May 11, 2012
- Last updated
- Nov 6, 2013
- 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 | 37001676A | IN | Primary |
Addresses
Primary practice location
1208 Flagstone Dr
Dyer, IN 46311-2290
Mailing address
1208 Flagstone Dr
Dyer, IN 46311-2290
Phone (219) 440-2708
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37001676A | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1255690160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1208 FLAGSTONE DR",
"city": "DYER",
"state": "IN",
"postal_code": "463112290",
"telephone_number": "219-440-2708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1208 FLAGSTONE DR",
"city": "DYER",
"state": "IN",
"postal_code": "463112290",
"telephone_number": "219-440-2708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHIUDDIN",
"first_name": "HUMAIRA",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-11",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37001676A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.