Roberto Carlos Correa, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2021000605 Issued in MO

Practice address

1271 Mountain Ridge Rd
Noel, MO 64854-7381

Phone

(479) 381-5582

NPI assigned

Oct 14, 2024

Last updated

Oct 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1679393771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 MOUNTAIN RIDGE RD",
            "city": "NOEL",
            "state": "MO",
            "postal_code": "648547381",
            "telephone_number": "479-381-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 MOUNTAIN RIDGE RD",
            "city": "NOEL",
            "state": "MO",
            "postal_code": "648547381",
            "telephone_number": "479-381-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "ROBERTO",
        "middle_name": "CARLOS",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2021000605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Bailey, PHD FNP-BC
• Rae Anna Beauford
• Joslyn Grace Harris
• Daisy Jacobo, COTA/L
• Ryan Lawson, APRN-CNP
• Karen Madsen, FNP
• Rosa Montero Maldonado

• Registered Dietitian in Noel, MO
• Providers in Noel, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.