Active NPI
Melissa Pryer, RD
- Registered Dietitian
- Mt. Vernon, IL
National Provider Identifier
1619438892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.006184
- Practice address
- 2020 Broadway, Suite 1
Mt. Vernon, IL 62864 - Phone
- (618) 927-0461
- NPI assigned
- Mar 28, 2019
- 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 | 164.006184 | IL | Primary |
Addresses
Primary practice location
2020 Broadway, Suite 1
Mt. Vernon, IL 62864
Mailing address
210 S Washington St
MC Leansboro, IL 62859-1139
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 |
|---|---|---|---|
| 164.006184 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575590400000",
"number": "1619438892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 S WASHINGTON ST",
"city": "MC LEANSBORO",
"state": "IL",
"postal_code": "628591139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 BROADWAY, SUITE 1",
"city": "MT. VERNON",
"state": "IL",
"postal_code": "62864",
"telephone_number": "618-927-0461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYER",
"first_name": "MELISSA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-28",
"last_updated": "2019-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.006184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mt. Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.