Active NPI
Janelle Middleton, RDN
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1396126363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37002534A
- Practice address
- 2003 W Fulton St
Chicago, IL 60612-2345 - Phone
- (312) 850-3438
- Fax
- (312) 638-9872
- NPI assigned
- Jun 15, 2015
- Last updated
- Jun 15, 2015
- 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 | 37002534A | IN | Primary |
Addresses
Primary practice location
2003 W Fulton St
Chicago, IL 60612-2345
Mailing address
22120 Scott Dr
Richton Park, IL 60471-1045
Phone (708) 856-2478
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150826001049 | IL | Practitioner - Registered Dietitian Or Nutrition Professional | 6204142938 | Practice locations: Chicago, IL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | 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": "1434326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434326400000",
"number": "1396126363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22120 SCOTT DR",
"city": "RICHTON PARK",
"state": "IL",
"postal_code": "604711045",
"telephone_number": "708-856-2478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2003 W FULTON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606122345",
"telephone_number": "312-850-3438",
"fax_number": "312-638-9872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDLETON",
"first_name": "JANELLE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-15",
"last_updated": "2015-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37002534A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.