Active NPI
Courtney Merrill, RDN
- Registered Dietitian
- Portland, OR
National Provider Identifier
1669171070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD-D-10225874
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 418-7157
- NPI assigned
- Feb 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD-D-10225874 | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
7937 SW 40TH Ave Apt C
Portland, OR 97219-3599
Phone (702) 408-7157
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 |
|---|---|---|---|
| LD-D-10225874 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677196800000",
"number": "1669171070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7937 SW 40TH AVE APT C",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972193599",
"telephone_number": "702-408-7157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-418-7157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "COURTNEY",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-24",
"last_updated": "2023-02-24",
"certification_date": "2023-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "LD-D-10225874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.