Active NPI
Denise Dee Imperial, RD
- Registered Dietitian
- Mishawaka, IN
National Provider Identifier
1417630179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 840037
- Practice address
- 301 E Day Rd
Mishawaka, IN 46545-3455 - Phone
- (574) 204-6465
- NPI assigned
- Aug 9, 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 | 840037 | IN | Primary |
Addresses
Primary practice location
301 E Day Rd
Mishawaka, IN 46545-3455
Mailing address
301 E Day Rd
Mishawaka, IN 46545-3455
Phone (574) 204-6465
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 |
|---|---|---|---|
| 840037 | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1417630179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E DAY RD",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465453455",
"telephone_number": "574-204-6465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E DAY RD",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465453455",
"telephone_number": "574-204-6465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMPERIAL",
"first_name": "DENISE",
"middle_name": "DEE",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-09",
"last_updated": "2023-08-09",
"certification_date": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "840037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
- Icr Adolescents Operating Subsidiary, LLC
- Icr South Bend Operating Subsidiary, LLC
- Sandy Imanse, LMSW
- Nancy Nasilele Imasiku, MSN, APRN, FNP
- David R Imes, OD
- Indiana Center for Recovery Adolescent Program LLC
- Indiana Center for Recovery South Bend, LLC
- Indiana Physicians Eyecare Group, P.C.
- Indiana Wellness RX 2 LLC
- Indiana Wellness RX LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.