Active NPI
Traci Layne Miller, RD
- Renal Nutrition Registered Dietitian
- Mineola, TX
National Provider Identifier
1447840681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- DT82554
- Practice address
- 2465 FM 1799
Mineola, TX 75773-4067 - Phone
- (190) 349-7866
- NPI assigned
- Jan 21, 2021
- Last updated
- Jan 21, 2021
- 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 |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | DT82554 | TX | Primary |
Addresses
Primary practice location
2465 FM 1799
Mineola, TX 75773-4067
Mailing address
PO Box 44
Golden, TX 75444-0044
Phone (903) 497-8668
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 |
|---|---|---|---|
| DT82554 | TX | MD | Renal Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1447840681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44",
"city": "GOLDEN",
"state": "TX",
"postal_code": "754440044",
"telephone_number": "903-497-8668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2465 FM 1799",
"city": "MINEOLA",
"state": "TX",
"postal_code": "757734067",
"telephone_number": "190-349-7866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "TRACI",
"middle_name": "LAYNE",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "TX",
"license": "DT82554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mineola, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.