Active NPI
Maja Hickman
- Registered Dietitian
- Blacksburg, VA
National Provider Identifier
1407312879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1095
- Practice address
- 2251 Woodland Hills Dr
Blacksburg, VA 24060-9269 - Phone
- (276) 698-7224
- NPI assigned
- Feb 11, 2019
- 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 | 1095 | WV | Primary |
Addresses
Primary practice location
2251 Woodland Hills Dr
Blacksburg, VA 24060-9269
Mailing address
2251 Woodland Hills Dr
Blacksburg, VA 24060-9269
Phone (276) 698-7224
Other names 1
- Maja Vukajlovic
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1095 | WV | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
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": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1407312879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2251 WOODLAND HILLS DR",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240609269",
"telephone_number": "276-698-7224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2251 WOODLAND HILLS DR",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240609269",
"telephone_number": "276-698-7224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "MAJA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-11",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "WV",
"license": "1095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MAJA",
"last_name": "VUKAJLOVIC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Blacksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.