Active NPI
Alexandra Grbcich
- Registered Dietitian
- O Fallon, MO
National Provider Identifier
1295430635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2023010602
- Practice address
- 18 W Industrial Dr
O Fallon, MO 63366-1926 - Phone
- (314) 626-3472
- NPI assigned
- Apr 4, 2023
- 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 | 2023010602 | MO | Primary |
Addresses
Primary practice location
18 W Industrial Dr
O Fallon, MO 63366-1926
Mailing address
18 W Industrial Dr
O Fallon, MO 63366-1926
Phone (314) 626-3472
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 |
|---|---|---|---|
| 2023010602 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Leaf Nutrition | Dietitian, Registered | Current | Accepting new patients |
| Cloud Health Medical Group, P.a. | Past | Accepting new patients | |
| Everfit Inc | Dietitian, Registered | Past | Accepting new patients |
| Cloud Health Medical Group of California, P.C. | Past | Accepting new patients |
Locations
18 W Industrial Dr
Ste 2
O Fallon, MO 63366
18 W Industrial Dr
O Fallon, MO 63366
Phone (314) 626-3472
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1194404327
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680566400000",
"number": "1295430635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 W INDUSTRIAL DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633661926",
"telephone_number": "314-626-3472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 W INDUSTRIAL DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633661926",
"telephone_number": "314-626-3472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRBCICH",
"first_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-04",
"last_updated": "2023-04-04",
"certification_date": "2023-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2023010602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.