Individual provider Active NPI

Kelly Miller, R. D.

  • Registered Dietitian
  • Salt Lake City, UT
National Provider Identifier
1629523782
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3637234901 Issued in UT
Practice address
295 S Chipeta Way
Suite 248
Salt Lake City, UT 84108-1287
Phone
(801) 213-3778
Fax
(801) 587-3001
NPI assigned
Aug 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3637234901 UT Primary

Addresses

Primary practice location

295 S Chipeta Way
Suite 248
Salt Lake City, UT 84108-1287

Mailing address

295 S Chipeta Way
Suite 248
Salt Lake City, UT 84108-1287
Phone (801) 213-3778

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

LicenseStateTypeSpecialty
3637234901UTMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1629523782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 S CHIPETA WAY",
            "address_2": "SUITE 248",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081287",
            "telephone_number": "801-213-3778",
            "fax_number": "801-587-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 S CHIPETA WAY",
            "address_2": "SUITE 248",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081287",
            "telephone_number": "801-213-3778",
            "fax_number": "801-587-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "R. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "3637234901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.

Verify at the official NPI Registry.