Active NPI
Celeste Durham, RD
- Registered Dietitian
- Gautier, MS
National Provider Identifier
1609812833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 724667
- Practice address
- 2101 Highway 90
Gautier, MS 39553-5340 - Phone
- (228) 497-8874
- Fax
- (228) 497-8869
- NPI assigned
- Jun 22, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 819 | LA | |
| Registered Dietitian | 133V00000X | 724667 | MS | Primary |
Addresses
Primary practice location
2101 Highway 90
Gautier, MS 39553-5340
Mailing address
2101 Highway 90
Gautier, MS 39553-5340
Phone (228) 497-8874
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 819 | LA | MD | Professional Counselor |
| 724667 | MS | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432857600000",
"number": "1609812833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 HIGHWAY 90",
"city": "GAUTIER",
"state": "MS",
"postal_code": "395535340",
"telephone_number": "228-497-8874",
"fax_number": "228-497-8869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 HIGHWAY 90",
"city": "GAUTIER",
"state": "MS",
"postal_code": "395535340",
"telephone_number": "228-497-8874",
"fax_number": "228-497-8869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURHAM",
"first_name": "CELESTE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2015-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "819",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MS",
"license": "724667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gautier, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.