Individual provider Active NPI

Meaghan S Mikulas, MS, RDN, LDN, CLC

  • Registered Dietitian
  • Charlotte, NC
National Provider Identifier
1326899519
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L004627 Issued in NC
Practice address
5310 Baker Dr
Charlotte, NC 28210-2820
Phone
(980) 406-9586
NPI assigned
Mar 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X L004627 NC Primary

Addresses

Primary practice location

5310 Baker Dr
Charlotte, NC 28210-2820

Mailing address

5310 Baker Dr
Charlotte, NC 28210-2820

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
L004627NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1326899519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 BAKER DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282102820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 BAKER DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282102820",
            "telephone_number": "980-406-9586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULAS",
        "first_name": "MEAGHAN",
        "middle_name": "S",
        "credential": "MS, RDN, LDN, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.