Active NPI
Audrey Smith Mitchell
- Registered Dietitian
- Whitesboro, TX
National Provider Identifier
1326622838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86010048
- Practice address
- 408 W Main St
Whitesboro, TX 76273-1641 - Phone
- (903) 816-3657
- NPI assigned
- May 11, 2021
- Last updated
- May 11, 2021
- 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 | 86010048 | TX | Primary |
Addresses
Primary practice location
408 W Main St
Whitesboro, TX 76273-1641
Mailing address
10811 Sandalwood Dr
Dallas, TX 75228-2410
Phone (254) 366-2300
Other names 1
- Audrey Smith
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://www.bariatricdietitians.com/ | Direct |
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 |
|---|---|---|---|
| 86010048 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Your Specialized Dietitian | 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": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1326622838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10811 SANDALWOOD DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752282410",
"telephone_number": "254-366-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 W MAIN ST",
"city": "WHITESBORO",
"state": "TX",
"postal_code": "762731641",
"telephone_number": "903-816-3657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "AUDREY",
"middle_name": "SMITH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-11",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "86010048",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://www.bariatricdietitians.com/",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "408 W Main St",
"city": "Whitesboro",
"state": "TX",
"country_code": "US",
"postal_code": "762731641",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "AUDREY",
"last_name": "SMITH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Whitesboro, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.