Active NPI
Maureen Mitchell, RD CSR
- Registered Dietitian
- Las Vegas, NV
National Provider Identifier
1679597272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 659674
- Practice address
- 4700 Las Vegas Blvd N
Las Vegas, NV 89191-6600 - Phone
- (702) 653-3679
- NPI assigned
- Jul 27, 2006
- 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 | 659674 | AZ | Primary |
Addresses
Primary practice location
4700 Las Vegas Blvd N
Las Vegas, NV 89191-6600
Mailing address
4700 Las Vegas Blvd N
Las Vegas, NV 89191-6600
Phone (702) 653-3679
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 659674 | AZ | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243468800000",
"number": "1679597272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891916600",
"telephone_number": "702-653-3679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 LAS VEGAS BLVD N",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891916600",
"telephone_number": "702-653-3679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "MAUREEN",
"credential": "RD CSR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2009-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "659674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.