Active NPI
Georganne Mackulin, RD
- Registered Dietitian
- Jefferson Hills, PA
National Provider Identifier
1447266358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN001493
- Practice address
- 565 Coal Valley Rd
Jefferson Hills, PA 15025-3703 - Phone
- (412) 469-5797
- Fax
- (412) 469-7725
- NPI assigned
- Jul 31, 2006
- 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 | DN001493 | PA | Primary |
Addresses
Primary practice location
565 Coal Valley Rd
Jefferson Hills, PA 15025-3703
Mailing address
141 Ridgewood Rd
Moon Township, PA 15108-2444
Phone (412) 469-5797
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 |
|---|---|---|---|
| DN001493 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447266358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 RIDGEWOOD RD",
"city": "MOON TOWNSHIP",
"state": "PA",
"postal_code": "151082444",
"telephone_number": "412-469-5797",
"fax_number": "412-469-7725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 COAL VALLEY RD",
"city": "JEFFERSON HILLS",
"state": "PA",
"postal_code": "150253703",
"telephone_number": "412-469-5797",
"fax_number": "412-469-7725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKULIN",
"first_name": "GEORGANNE",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN001493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson Hills, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.