Individual provider Active NPI

Mia Johnson

  • Registered Dietitian
  • Cincinnati, OH
National Provider Identifier
1679400527
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD.10717 Issued in OH
Practice address
4440 Red Bank Rd
Cincinnati, OH 45227-2176
Phone
(513) 585-2668
NPI assigned
May 5, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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 LD.10717 OH Primary

Addresses

Primary practice location

4440 Red Bank Rd
Cincinnati, OH 45227-2176

Mailing address

4440 Red Bank Rd
Cincinnati, OH 45227-2176
Phone (513) 585-2668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260603004168 OH Practitioner - Registered Dietitian Or Nutrition Professional 7618448341 Reassigns benefits to 1 organization
I20260603004244 KY Practitioner - Registered Dietitian Or Nutrition Professional 7618448341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2139 Auburn Ave
4 9
Cincinnati, OH 45219-2989

2139 Auburn Ave
Payor Enrollment 4 7
Cincinnati, OH 45219-2610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD.10717OHMDRegistered Dietitian

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.

NPI Registry JSON

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

{
    "created_epoch": "1777939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1679400527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 RED BANK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452272176",
            "telephone_number": "513-585-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 RED BANK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452272176",
            "telephone_number": "513-585-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-05",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD.10717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.