Sara Marie Mickelson, R.D., M.B.A.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1062741 Issued in UT

Practice address

1990 S McClelland St Apt 15
Salt Lake City, UT 84105-3456

Phone

(310) 529-2455

NPI assigned

Sep 5, 2013

Last updated

Sep 5, 2013By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

State licenses

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1518392893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 S MCCLELLAND ST APT 15",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053456",
            "telephone_number": "310-529-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 S MCCLELLAND ST APT 15",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053456",
            "telephone_number": "310-529-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "SARA",
        "middle_name": "MARIE",
        "credential": "R.D., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "1062741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Gourley & Associates, LLC
• Julia Kleschen Michels
• Kim James Michelson, D.D.S.
• Ivana Micic
• Meagan Ann Mickelsen
• Janelle Miconi
• Middleton Urological Associates
• Anthony W Middleton Jr., M.D.
• Elizabeth Anne Middleton, M.D.
• Ingrid Maria Middleton, LCSW

• Registered Dietitian in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Registered Dietitian in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.