Active NPI
Michelle Grace Burgos, RD
- Registered Dietitian
- Sugar Land, TX
National Provider Identifier
1376301085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT88436
- Practice address
- 17520 W Grand Pkwy S.
Suite110
Sugarland, TX 77479 - Phone
- (281) 239-3777
- Fax
- (281) 239-3744
- NPI assigned
- Mar 7, 2024
- 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 | DT88436 | TX | Primary |
Addresses
Primary practice location
17520 W Grand Pkwy S.
Suite110
Sugarland, TX 77479
Mailing address
17520 W Grand Pkwy S.
Suite110
Sugarland, TX 77479
Phone (281) 239-3777
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 |
|---|---|---|---|
| DT88436 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New 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, 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": "1709769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709769600000",
"number": "1376301085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17520 W GRAND PKWY S.",
"address_2": "SUITE110",
"city": "SUGARLAND",
"state": "TX",
"postal_code": "77479",
"telephone_number": "281-239-3777",
"fax_number": "281-239-3744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17520 W GRAND PKWY S.",
"address_2": "SUITE110",
"city": "SUGARLAND",
"state": "TX",
"postal_code": "77479",
"telephone_number": "281-239-3777",
"fax_number": "281-239-3744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGOS",
"first_name": "MICHELLE",
"middle_name": "GRACE",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-07",
"last_updated": "2024-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT88436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.