Individual provider Active NPI

Callie Trice, R.D.

  • Registered Dietitian
  • Madison, MS
National Provider Identifier
1255984472
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
401 Baptist Dr Ste 301
Madison, MS 39110-2012
Phone
(601) 499-0935
Fax
(601) 499-0936
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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 Primary

Addresses

Primary practice location

401 Baptist Dr Ste 301
Madison, MS 39110-2012

Mailing address

7731 Old Canton Rd Ste B
Madison, MS 39110-6115
Phone (601) 499-0935

Other identifiers 1

IdentifierTypeStateIssuer
01527231MedicaidMS

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1255984472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7731 OLD CANTON RD STE B",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106115",
            "telephone_number": "601-499-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DR STE 301",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102012",
            "telephone_number": "601-499-0935",
            "fax_number": "601-499-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRICE",
        "first_name": "CALLIE",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01527231",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.