Individual provider Active NPI

Mia Samantha Fishkin, MPH, RDN, LDN

  • Registered Dietitian
  • North Providence, RI
National Provider Identifier
1376406066
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1635 Mineral Spring Ave Ste 205
North Providence, RI 02904-4025
Phone
(401) 305-6602
Fax
(401) 305-6617
NPI assigned
Dec 8, 2025
Last updated
Mar 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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 NU Primary

Addresses

Primary practice location

1635 Mineral Spring Ave Ste 205
North Providence, RI 02904-4025

Mailing address

48 Homefield Ave
Providence, RI 02908-1810

Other practice location 1

48 Homefield Ave
Providence, RI 02908-1810
Phone (862) 206-9428

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260408000260 RI Practitioner - Registered Dietitian Or Nutrition Professional 8729553755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of North Carolina at Chapel Hill School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Resolutions LLCGroup PAC ID 3476537945, 4 clinicians

Practice addresses (Care Compare)

1635 Mineral Spring Ave
Suite 205
North Providence, RI 02904-4025
Phone (401) 305-6602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Resolutions, LLC Dietitian, Registered CurrentSince Mar 5, 2026 Accepting new patients

Locations

1635 Mineral Spring Ave
Ste 205
North Providence, RI 02904
Phone (401) 305-6602

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": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1376406066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 HOMEFIELD AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029081810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 MINERAL SPRING AVE STE 205",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044025",
            "telephone_number": "401-305-6602",
            "fax_number": "401-305-6617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 Homefield Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029081810",
            "country_code": "US",
            "telephone_number": "862-206-9428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHKIN",
        "first_name": "MIA",
        "middle_name": "SAMANTHA",
        "credential": "MPH, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.