Gloria Ivana Mitchell, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1802 Sara Dr Apt a
College Station, TX 77845-5860

Phone

(804) 982-0002

NPI assigned

Oct 23, 2023

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Gloria Ivana Effendi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1457123549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 SARA DR APT A",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 SARA DR APT A",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455860",
            "telephone_number": "804-982-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "GLORIA",
        "middle_name": "IVANA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "EFFENDI",
            "middle_name": "IVANA",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Anne Miner
• Sweden Michaela Minor Israel, RBT
• Jacob Steven Minor, M.D.
• Monika Mishra, M.D.
• Mitchell Enterprises Staffing Agency
• Lakita H Mitchell
• Daniella Mariana Mittan, MD
• Roxane G Mlcak, DDS
• Mmci, Inc
• Mobile Docs PLLC

• Registered Dietitian in College Station, TX
• Providers in College Station, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.

Verify at the official NPI Registry.