Individual provider Active NPI

Melissa N Ratliff, RD

  • Registered Dietitian
  • Glendale, AZ
National Provider Identifier
1497024533
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1049889 Issued in AZ
Practice address
17505 N 79TH Ave
Suite 110
Glendale, AZ 85308-8725
Phone
(623) 399-6825
Fax
(623) 505-3474
NPI assigned
Dec 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1049889 AZ Primary

Addresses

Primary practice location

17505 N 79TH Ave
Suite 110
Glendale, AZ 85308-8725

Mailing address

17505 N 79TH Ave
Suite 110
Glendale, AZ 85308-8725
Phone (623) 399-6825

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

LicenseStateTypeSpecialty
1049889AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Am Nutrition Services Dietitian, Registered PastSince May 15, 2013 Accepting new patients

Organizations & group practices 1

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": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1497024533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17505 N 79TH AVE",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088725",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17505 N 79TH AVE",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088725",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "MELISSA",
        "middle_name": "N",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "1049889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.