NPIMap

Individual provider Active NPI

Greta K McKenzie, MS, RD

  • Registered Dietitian
  • Fishers, IN
National Provider Identifier
1609207992
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
707829 Issued in IN
Practice address
13848 Dearborn Cir
Suite 100
Fishers, IN 46038-7470
Phone
(317) 373-1223
NPI assigned
Dec 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 707829 IN Primary

Addresses

Primary practice location

13848 Dearborn Cir
Suite 100
Fishers, IN 46038-7470

Mailing address

13848 Dearborn Cir
Suite 100
Fishers, IN 46038-7470
Phone (317) 373-1223

Other names 1

  • Greta K Mellas Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
707829INMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1609207992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13848 DEARBORN CIR",
            "address_2": "SUITE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460387470",
            "telephone_number": "317-373-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13848 DEARBORN CIR",
            "address_2": "SUITE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460387470",
            "telephone_number": "317-373-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "GRETA",
        "middle_name": "K",
        "credential": "MS, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "707829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRETA",
            "last_name": "MELLAS",
            "middle_name": "K",
            "credential": "MS, RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.