Individual provider Active NPI

Ellen Marie Michal, RD

  • Registered Dietitian
  • Raleigh, NC
National Provider Identifier
1366852329
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L001531 Issued in NC
Practice address
3301 Executive Dr
Raleigh, NC 27609-7432
Phone
(919) 954-3174
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 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 L001531 NC Primary

Addresses

Primary practice location

3301 Executive Dr
Raleigh, NC 27609-7432

Mailing address

3301 Executive Dr
Raleigh, NC 27609-7432
Phone (919) 954-3174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826001840 NC Practitioner - Registered Dietitian Or Nutrition Professional 4385972520 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Duke Health Integrated Practice, Inc CurrentSince Jan 1, 2025 Accepting new patients
Duke University Health System, Inc. Dietitian, Registered CurrentSince Jun 1, 2024 Accepting new patients

Locations

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3480 Wake Forest Rd
Ste 502
Raleigh, NC 27609
Phone (919) 420-5000

Organizations & group practices 3

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1366852329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 EXECUTIVE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097432",
            "telephone_number": "919-954-3174",
            "fax_number": "919-954-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 EXECUTIVE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097432",
            "telephone_number": "919-954-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAL",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L001531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.