Active NPI
Carolyn Mergen
- Registered Dietitian
- Fort Riley, KS
National Provider Identifier
1588254262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2388
- Practice address
- 55578 Longstreet Dr Apt 1
Fort Riley, KS 66442-3677 - Phone
- (714) 234-0262
- NPI assigned
- Jan 26, 2021
- 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 | 2388 | KS | Primary |
Addresses
Primary practice location
55578 Longstreet Dr Apt 1
Fort Riley, KS 66442-3677
Mailing address
650 Huebner Rd
Fort Riley, KS 66442-4030
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 |
|---|---|---|---|
| 2388 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611619200000",
"number": "1588254262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 HUEBNER RD",
"city": "FORT RILEY",
"state": "KS",
"postal_code": "664424030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55578 LONGSTREET DR APT 1",
"city": "FORT RILEY",
"state": "KS",
"postal_code": "664423677",
"telephone_number": "714-234-0262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERGEN",
"first_name": "CAROLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-26",
"last_updated": "2021-01-26",
"certification_date": "2021-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KS",
"license": "2388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Riley, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.