Active NPI
Mia L Funcheon, RDN
- Registered Dietitian
- Newtown, PA
National Provider Identifier
1477279594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 842 Durham Rd Ste 200
Newtown, PA 18940-9680 - Phone
- (267) 364-5396
- NPI assigned
- Oct 19, 2022
- Last updated
- Oct 19, 2022
- 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 | NU | Primary |
Addresses
Primary practice location
842 Durham Rd Ste 200
Newtown, PA 18940-9680
Mailing address
842 Durham Rd Ste 200
Newtown, PA 18940-9680
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mia@beyondnewtown.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4624 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 3 Dimensional Physical Therapy - Pelvic Health LLC | Past | Accepting new patients | |
| Nourish & Flourish Nutrition Therapy | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Medford, NJ
- NPI 1275348500
-
- Registered Dietitian
- Hillsborough, NJ
- NPI 1427828391
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1477279594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "842 DURHAM RD STE 200",
"city": "NEWTOWN",
"state": "PA",
"postal_code": "189409680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "842 DURHAM RD STE 200",
"city": "NEWTOWN",
"state": "PA",
"postal_code": "189409680",
"telephone_number": "267-364-5396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNCHEON",
"first_name": "MIA",
"middle_name": "L",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-19",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mia@beyondnewtown.com",
"affiliation": "N",
"endpointDescription": "professional email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "842 Durham Rd Ste 200",
"city": "Newtown",
"state": "PA",
"country_code": "US",
"postal_code": "189409680",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Newtown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.