Active NPI
Miranda Katelynn Smith, RD, LD
- Registered Dietitian
- La Grange, KY
National Provider Identifier
1548762917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 124585
- Practice address
- 4603 Timberwalk CT
La Grange, KY 40031-6746 - Phone
- (703) 864-6695
- Fax
- (888) 830-3233
- NPI assigned
- Mar 1, 2018
- 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 | 124585 | KY | Primary |
Addresses
Primary practice location
4603 Timberwalk CT
La Grange, KY 40031-6746
Mailing address
7113 Green Spring Dr
Louisville, KY 40241-1016
Phone (502) 539-4767
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124585 | KY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascb Therapy LLC | Dietitian, Registered | Current | 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": "1519862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585267200000",
"number": "1548762917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7113 GREEN SPRING DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402411016",
"telephone_number": "502-539-4767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4603 TIMBERWALK CT",
"city": "LA GRANGE",
"state": "KY",
"postal_code": "400316746",
"telephone_number": "703-864-6695",
"fax_number": "888-830-3233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MIRANDA",
"middle_name": "KATELYNN",
"name_prefix": "Mrs.",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-01",
"last_updated": "2020-03-27",
"certification_date": "2020-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "124585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Grange, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.