Active NPI
Michelle Ann Degraaf, RDN LD
- Registered Dietitian
- Dayton, OH
National Provider Identifier
1619507258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD.4849
- Practice address
- 1 Childrens PLZ
Dayton, OH 45404-1815 - Phone
- (937) 641-3495
- NPI assigned
- Jan 23, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD.4849 | OH | Primary |
Addresses
Primary practice location
1 Childrens PLZ
Dayton, OH 45404-1815
Mailing address
40 Heston Dr
Springboro, OH 45066-1081
Phone (937) 470-5469
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 |
|---|---|---|---|
| LD.4849 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579737600000",
"number": "1619507258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 HESTON DR",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450661081",
"telephone_number": "937-470-5469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PLZ",
"city": "DAYTON",
"state": "OH",
"postal_code": "454041815",
"telephone_number": "937-641-3495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRAAF",
"first_name": "MICHELLE",
"middle_name": "ANN",
"credential": "RDN LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-23",
"last_updated": "2020-01-23",
"certification_date": "2020-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD.4849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.