Active NPI
Jacqueline Nicole Michaelis, MS, RDN, LD
- Registered Dietitian
- Sandusky, OH
National Provider Identifier
1467978916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD.8100
- Practice address
- 417 Quarry Lakes Dr
Sandusky, OH 44870-8635 - Phone
- (419) 626-9090
- NPI assigned
- Aug 16, 2017
- 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 | LD.8100 | OH | Primary |
Addresses
Primary practice location
417 Quarry Lakes Dr
Sandusky, OH 44870-8635
Mailing address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (800) 223-2273
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD.8100 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682294400000",
"number": "1467978916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "800-223-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 QUARRY LAKES DR",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448708635",
"telephone_number": "419-626-9090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAELIS",
"first_name": "JACQUELINE",
"middle_name": "NICOLE",
"credential": "MS, RDN, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-16",
"last_updated": "2023-04-24",
"certification_date": "2023-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD.8100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandusky, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.