Active NPI
Michelle Pearson, RD
- Registered Dietitian
- Berea, KY
National Provider Identifier
1619371135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 163411
- Practice address
- 209 Pauline Dr
Berea, KY 40403-8889 - Phone
- (859) 986-1259
- NPI assigned
- Oct 13, 2014
- Last updated
- Oct 11, 2016
- 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 | 86020603 | OH | |
| Registered Dietitian | 133V00000X | 163411 | KY | Primary |
Addresses
Primary practice location
209 Pauline Dr
Berea, KY 40403-8889
Mailing address
209 Pauline Dr
Berea, KY 40403-8889
Phone (859) 475-8345
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 |
|---|---|---|---|
| 163411 | KY | MD | Registered Dietitian |
| 86020603 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1619371135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 PAULINE DR",
"city": "BEREA",
"state": "KY",
"postal_code": "404038889",
"telephone_number": "859-475-8345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 PAULINE DR",
"city": "BEREA",
"state": "KY",
"postal_code": "404038889",
"telephone_number": "859-986-1259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "MICHELLE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-13",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "86020603",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "163411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berea, KY
- Melanie Parsons, BS
- Kela Parton
- Peace of Mind Healthcare PLLC
- Peace of Mind Home Care LLC (Peace of Mind Home Care)
- Carol Lynne Peachee, CAROL PEACHEE, LPCC
- Jessica Abney Pennington, MD
- Gwendolyn Dawn Perch, APRN
- Kathryn Coleen Phillips, CSW
- Pierce Healthcare Solutions LLC
- Pinnacle Pediatric Dentistry, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.