Active NPI
Carly A Secord, RD
- Registered Dietitian
- Eaton Rapids, MI
National Provider Identifier
1285183855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86027704
- Practice address
- 1500 S Main St
Eaton Rapids, MI 48827-1952 - Phone
- (517) 663-9453
- NPI assigned
- Sep 23, 2016
- Last updated
- Sep 23, 2016
- 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 | 86027704 | MI | Primary |
Addresses
Primary practice location
1500 S Main St
Eaton Rapids, MI 48827-1952
Mailing address
1500 S Main St
Eaton Rapids, MI 48827-1952
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 |
|---|---|---|---|
| 86027704 | MI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1285183855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S MAIN ST",
"city": "EATON RAPIDS",
"state": "MI",
"postal_code": "488271952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 S MAIN ST",
"city": "EATON RAPIDS",
"state": "MI",
"postal_code": "488271952",
"telephone_number": "517-663-9453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SECORD",
"first_name": "CARLY",
"middle_name": "A",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-23",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "86027704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eaton Rapids, MI
- Rite Aid of Michigan Inc (Rite Aid Pharmacy 04600)
- Lynsey Rogers
- Cailee Marie Sanchez, APRN, NP
- Sandy Transitions MHT LLC
- Rick Adam Schuster, PT, DPT
- Jessica Mae Seguin, CCC-SLP
- Diane Jill Shawa, CPHT
- Joseph John Sheneman, D.C.
- Nicole Sparks, O.D.
- Specialists in Blood Pressure and Kidney Disease PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.