Michelle Dougherty Rd Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

MICHELLE DOUGHERTY RD NUTRITION, LLC

Practice address

100 E Hanover Ave # 401B
Cedar Knolls, NJ 07927-2020

Phone

(908) 337-6599

Fax

(833) 696-0781

NPI assigned

Feb 23, 2021

Organization subpart

No

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

Authorized official

Name

Michelle Dougherty, RDNPI 1295161651

Title

Owner

Phone

(908) 337-6599

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Dougherty, R.D.

  • Registered Dietitian
  • Cedar Knolls, NJ
  • NPI 1295161651

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1659965440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E HANOVER AVE # 401B",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272020",
            "telephone_number": "908-337-6599",
            "fax_number": "833-696-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E HANOVER AVE # 401B",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272020",
            "telephone_number": "908-337-6599",
            "fax_number": "833-696-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE DOUGHERTY RD NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-23",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-337-6599",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Cedar Knolls, NJ
• Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.