Active NPI
Michael Jude Libbey Sr., R.D.,C.D.E.
- Registered Dietitian
- Youngstown, OH
National Provider Identifier
1508086430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD 2524
- Practice address
- 72 Woodview Ave
Youngstown, OH 44512-4645 - Phone
- (330) 881-6439
- Fax
- (330) 726-5465
- NPI assigned
- Apr 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 2524 | OH | Primary |
Addresses
Primary practice location
72 Woodview Ave
Youngstown, OH 44512-4645
Mailing address
72 Woodview Ave
Youngstown, OH 44512-4645
Phone (330) 881-6439
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 |
|---|---|---|---|
| LD 2524 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508086430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 WOODVIEW AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445124645",
"telephone_number": "330-881-6439",
"fax_number": "330-726-5465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 WOODVIEW AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445124645",
"telephone_number": "330-881-6439",
"fax_number": "330-726-5465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBBEY",
"first_name": "MICHAEL",
"middle_name": "JUDE",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "R.D.,C.D.E.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD 2524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.