Active NPI
Eleanor Kathryn Erickson Thach, MS, RDN
- Registered Dietitian
- Ann Arbor, MI
National Provider Identifier
1679277149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1048912
- Practice address
- 105 Worden Ave
Ann Arbor, MI 48103-4031 - Phone
- (919) 357-4544
- NPI assigned
- Mar 29, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1048912 | MI | Primary |
Addresses
Primary practice location
105 Worden Ave
Ann Arbor, MI 48103-4031
Mailing address
105 Worden Ave
Ann Arbor, MI 48103-4031
Phone (919) 357-4544
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1048912 | MI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Joseph Mercy Hospital | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1265497705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680048000000",
"number": "1679277149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 WORDEN AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481034031",
"telephone_number": "919-357-4544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 WORDEN AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481034031",
"telephone_number": "919-357-4544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACH",
"first_name": "ELEANOR KATHRYN",
"middle_name": "ERICKSON",
"name_prefix": "Mrs.",
"credential": "MS, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-29",
"last_updated": "2023-03-29",
"certification_date": "2023-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "1048912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.