Individual provider Active NPI

Michelle Kuimba, RDN, LDN

  • Registered Dietitian
  • Baltimore, MD
National Provider Identifier
1275204547
Registry record updated Sep 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX5028 Issued in MD
Practice address
1734 Maryland Ave Ste 200
Baltimore, MD 21201-5804
Phone
(240) 722-1014
NPI assigned
Sep 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DX5028 MD Primary
Registered Dietitian 133V00000X DI100001197 DC

Addresses

Primary practice location

1734 Maryland Ave Ste 200
Baltimore, MD 21201-5804

Mailing address

3925 Beech Ave Apt 421
Baltimore, MD 21211-2262
Phone (202) 470-8276

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

LicenseStateTypeSpecialty
DI100001197DCMDRegistered Dietitian
DX5028MDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Body Image Therapy Center Intensive Dietitian, Registered CurrentSince Oct 5, 2021 Accepting new patients

Locations

1734 Maryland Ave
Ste 200
Baltimore, MD 21201
Phone (240) 722-1014

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": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1275204547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 BEECH AVE APT 421",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112262",
            "telephone_number": "202-470-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1734 MARYLAND AVE STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015804",
            "telephone_number": "240-722-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUIMBA",
        "first_name": "MICHELLE",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-25",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX5028",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DC",
            "license": "DI100001197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.

Verify at the official NPI Registry.