Active NPI
Megan Ann Vallas, MS, RDN, LDN
- Registered Dietitian
- Canton, IL
National Provider Identifier
1386350502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164009066
- Practice address
- 210 W Walnut St
Canton, IL 61520-2497 - Phone
- (309) 647-5240
- NPI assigned
- Jan 31, 2023
- Last updated
- Jan 31, 2023
- 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 | 164009066 | IL | Primary |
Addresses
Primary practice location
210 W Walnut St
Canton, IL 61520-2497
Mailing address
306 W Market St
Yates City, IL 61572-9206
Phone (309) 712-2479
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
| License | State | Type | Specialty |
|---|---|---|---|
| 164009066 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1386350502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 W MARKET ST",
"city": "YATES CITY",
"state": "IL",
"postal_code": "615729206",
"telephone_number": "309-712-2479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 W WALNUT ST",
"city": "CANTON",
"state": "IL",
"postal_code": "615202497",
"telephone_number": "309-647-5240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLAS",
"first_name": "MEGAN",
"middle_name": "ANN",
"credential": "MS, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-31",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164009066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.