Active NPI
Michele M Radack, RD/LN
- Registered Dietitian
- Yankton, SD
National Provider Identifier
1619273919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 0240
- Practice address
- 501 Summit St
Yankton, SD 57078-3855 - Phone
- (605) 668-8000
- Fax
- (605) 668-8720
- NPI assigned
- Feb 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 0240 | SD | Primary |
Addresses
Primary practice location
501 Summit St
Yankton, SD 57078-3855
Mailing address
501 Summit St
Yankton, SD 57078-3855
Phone (605) 668-8000
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 |
|---|---|---|---|
| 0240 | SD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296691200000",
"number": "1619273919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 SUMMIT ST",
"city": "YANKTON",
"state": "SD",
"postal_code": "570783855",
"telephone_number": "605-668-8000",
"fax_number": "605-668-8720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 SUMMIT ST",
"city": "YANKTON",
"state": "SD",
"postal_code": "570783855",
"telephone_number": "605-668-8000",
"fax_number": "605-668-8720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADACK",
"first_name": "MICHELE",
"middle_name": "M",
"credential": "RD/LN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-03",
"last_updated": "2011-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SD",
"license": "0240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yankton, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.