Active NPI
Makeda Damali Mogerie Mars, RDN LD
- Registered Dietitian
- Atlanta, GA
National Provider Identifier
1447893789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD004203
- Practice address
- 3640 Fairburn PL NW
Atlanta, GA 30331-1422 - Phone
- (404) 735-4655
- NPI assigned
- Oct 18, 2019
- 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 | LD004203 | GA | Primary |
Addresses
Primary practice location
3640 Fairburn PL NW
Atlanta, GA 30331-1422
Mailing address
3640 Fairburn PL NW
Atlanta, GA 30331-1422
Phone (404) 735-4655
Other names 1
- Makeda Damali Mogerie
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 |
|---|---|---|---|
| LD004203 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1571356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571356800000",
"number": "1447893789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3640 FAIRBURN PL NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303311422",
"telephone_number": "404-735-4655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3640 FAIRBURN PL NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303311422",
"telephone_number": "404-735-4655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARS",
"first_name": "MAKEDA",
"middle_name": "DAMALI MOGERIE",
"credential": "RDN LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-18",
"last_updated": "2019-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD004203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MAKEDA",
"last_name": "MOGERIE",
"middle_name": "DAMALI",
"credential": "RDN LD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.