Active NPI
Michelle Kuimba, RDN, LDN
- Registered Dietitian
- Baltimore, MD
National Provider Identifier
1275204547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DX5028
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| DI100001197 | DC | MD | Registered Dietitian |
| DX5028 | MD | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Body Image Therapy Center Intensive | Dietitian, Registered | Current | 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.
-
- Multi-Specialty Clinic/Center
- Washington, DC
- NPI 1982035994
Dietitian, Registered
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.