Active NPI
Alicia Wilson
- Registered Dietitian
- Sandy Springs, GA
National Provider Identifier
1376964684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 885121
- Practice address
- 8740 Roswell Rd Unit 10D
Sandy Springs, GA 30350-1831 - Phone
- (770) 837-5577
- NPI assigned
- Jan 5, 2014
- 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 | 885121 | GA | Primary |
Addresses
Primary practice location
8740 Roswell Rd Unit 10D
Sandy Springs, GA 30350-1831
Mailing address
8352 Roswell Rd Apt Roswell
Atlanta, GA 30350-2812
Phone (770) 837-5777
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 885121 | GA | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630108800000",
"number": "1376964684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8352 ROSWELL RD APT ROSWELL",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303502812",
"telephone_number": "770-837-5777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8740 ROSWELL RD UNIT 10D",
"city": "SANDY SPRINGS",
"state": "GA",
"postal_code": "303501831",
"telephone_number": "770-837-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ALICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-05",
"last_updated": "2021-08-28",
"certification_date": "2021-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "885121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.