Active NPI
Mirabella Macias
- Registered Dietitian
- Las Cruces, NM
National Provider Identifier
1598353906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1324
- Practice address
- 2700 Boldt St
Las Cruces, NM 88005-3876 - Phone
- (575) 640-2758
- NPI assigned
- Jan 2, 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 | 1324 | NM | Primary |
Addresses
Primary practice location
2700 Boldt St
Las Cruces, NM 88005-3876
Mailing address
2700 Boldt St
Las Cruces, NM 88005-3876
Phone (575) 640-2758
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 |
|---|---|---|---|
| 1324 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uniquely Healthy | 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": "1609545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609545600000",
"number": "1598353906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 BOLDT ST",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053876",
"telephone_number": "575-640-2758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 BOLDT ST",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053876",
"telephone_number": "575-640-2758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACIAS",
"first_name": "MIRABELLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-02",
"last_updated": "2021-01-02",
"certification_date": "2021-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NM",
"license": "1324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.