Individual provider Active NPI

Michon Lynette Powell, MS, CNS, LDN

  • Nutritionist
  • Clinton, MD
National Provider Identifier
1629595533
Registry record updated Aug 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
DX3766 Issued in MD
Practice address
9135 Piscataway Rd
Clinton, MD 20735-2549
Phone
(240) 348-7860
NPI assigned
Aug 23, 2017
Last updated
Aug 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133N00000X DX3766 MD Primary

Addresses

Primary practice location

9135 Piscataway Rd
Clinton, MD 20735-2549

Mailing address

9603 Greyfield CT
Bowie, MD 20721-3180
Phone (301) 466-6493

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
Credentials
Certified Nurse Specialist, Master of Science

State licenses

LicenseStateTypeSpecialty
DX3766MDMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Partnering4Wellness Nutritionist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1629595533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9603 GREYFIELD CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207213180",
            "telephone_number": "301-466-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 PISCATAWAY RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352549",
            "telephone_number": "240-348-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "MICHON",
        "middle_name": "LYNETTE",
        "credential": "MS, CNS, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX3766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; 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.