Active NPI
Sara Mallinckrodt, RD
- Registered Dietitian
- Jefferson City, MO
National Provider Identifier
1275417248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 1606 Northway Dr
Jefferson City, MO 65109-0489 - Phone
- (636) 538-0020
- NPI assigned
- Aug 4, 2025
- Last updated
- Aug 4, 2025
- 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 | Primary |
Addresses
Primary practice location
1606 Northway Dr
Jefferson City, MO 65109-0489
Mailing address
1606 Northway Dr
Jefferson City, MO 65109-0489
Phone (636) 538-0200
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754265600000",
"number": "1275417248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1606 NORTHWAY DR",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651090489",
"telephone_number": "636-538-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 NORTHWAY DR",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651090489",
"telephone_number": "636-538-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLINCKRODT",
"first_name": "SARA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-04",
"last_updated": "2025-08-04",
"certification_date": "2025-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.