Individual provider Active NPI

George Datsenko, RDN

  • Registered Dietitian
  • Clawson, MI
National Provider Identifier
1659199032
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1050445 Issued in MI
Practice address
353 Madison Ave
Clawson, MI 48017-1974
Phone
(248) 688-7858
NPI assigned
Oct 2, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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 1050445 MI Primary

Addresses

Primary practice location

353 Madison Ave
Clawson, MI 48017-1974

Mailing address

353 Madison Ave
Clawson, MI 48017-1974
Phone (248) 688-7858

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

LicenseStateTypeSpecialty
1050445MIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1659199032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 MADISON AVE",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480171974",
            "telephone_number": "248-688-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 MADISON AVE",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480171974",
            "telephone_number": "248-688-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATSENKO",
        "first_name": "GEORGE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "1050445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clawson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.