Active NPI
Raylentina Latoya Dickey, RD, LD
- Registered Dietitian
- Union City, GA
National Provider Identifier
1649543877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD003485
- Practice address
- 10104 Deep Creek Dr
Union City, GA 30291-1098 - Phone
- (404) 788-5217
- NPI assigned
- Feb 19, 2012
- Last updated
- Jan 29, 2025
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L007163 | NC | |
| Registered Dietitian | 133V00000X | DX6105 | MD | |
| Registered Dietitian | 133V00000X | LD003485 | GA | Primary |
Addresses
Primary practice location
10104 Deep Creek Dr
Union City, GA 30291-1098
Mailing address
10104 Deep Creek Dr
Union City, GA 30291-1098
Phone (404) 788-5217
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 |
|---|---|---|---|
| LD003485 | GA | MD | Registered Dietitian |
| DX6105 | MD | MD | Registered Dietitian |
| L007163 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| It Is Well Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1329609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1649543877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10104 DEEP CREEK DR",
"city": "UNION CITY",
"state": "GA",
"postal_code": "302911098",
"telephone_number": "404-788-5217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10104 DEEP CREEK DR",
"city": "UNION CITY",
"state": "GA",
"postal_code": "302911098",
"telephone_number": "404-788-5217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKEY",
"first_name": "RAYLENTINA",
"middle_name": "LATOYA",
"name_prefix": "Miss",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-19",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L007163",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX6105",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD003485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.