Individual provider Active NPI

Meagan Marie Maggiore, RD

  • Registered Dietitian
  • Stockton, CA
National Provider Identifier
1639613326
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86030507 Issued in CA
Practice address
1617 N California St Ste 2G
Stockton, CA 95204-6117
Phone
(209) 461-5268
NPI assigned
Dec 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 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 86030507 CA Primary

Addresses

Primary practice location

1617 N California St Ste 2G
Stockton, CA 95204-6117

Mailing address

1617 N California St Ste 2G
Stockton, CA 95204-6117
Phone (209) 461-5268

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
86030507CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1639613326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 N CALIFORNIA ST STE 2G",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046117",
            "telephone_number": "209-461-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N CALIFORNIA ST STE 2G",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046117",
            "telephone_number": "209-461-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGIORE",
        "first_name": "MEAGAN",
        "middle_name": "MARIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86030507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.