Individual provider Active NPI

Dawn Vergin, R.D.

  • Registered Dietitian
  • Detroit, MI
National Provider Identifier
1396288288
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
886904
Practice address
22151 Moross Rd Ste 135
Detroit, MI 48236-2165
Phone
(313) 343-7047
NPI assigned
Nov 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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 886904 Primary

Addresses

Primary practice location

22151 Moross Rd Ste 135
Detroit, MI 48236-2165

Mailing address

22151 Moross Rd Ste 135
Detroit, MI 48236-2165
Phone (313) 343-7047

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1396288288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22151 MOROSS RD STE 135",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362165",
            "telephone_number": "313-343-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22151 MOROSS RD STE 135",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362165",
            "telephone_number": "313-343-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGIN",
        "first_name": "DAWN",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "886904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.