Active NPI
Janet Mytrice Childre, RD
- Registered Dietitian
- Rome, GA
National Provider Identifier
1285926253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD000129
- Practice address
- 304 Turner McCall Blvd SW
Rome, GA 30165-5621 - Phone
- (706) 509-5000
- NPI assigned
- May 10, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD000129 | GA | Primary |
Addresses
Primary practice location
304 Turner McCall Blvd SW
Rome, GA 30165-5621
Mailing address
PO Box 1882
Rome, GA 30162-1882
Phone (706) 509-3278
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 |
|---|---|---|---|
| LD000129 | GA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304985600000",
"number": "1285926253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1882",
"city": "ROME",
"state": "GA",
"postal_code": "301621882",
"telephone_number": "706-509-3278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 TURNER MCCALL BLVD SW",
"city": "ROME",
"state": "GA",
"postal_code": "301655621",
"telephone_number": "706-509-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDRE",
"first_name": "JANET",
"middle_name": "MYTRICE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-10",
"last_updated": "2011-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD000129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.