Individual provider Active NPI

Patricia M Reid, RDN, CDCES

  • Registered Dietitian
  • Novi, MI
National Provider Identifier
1679826341
Registry record updated Apr 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1052645 Issued in MI
Practice address
39450 W 12 Mile Road
Diabetes Care Connections 3Rd Floor
Novi, MI 48377
Phone
(313) 574-2152
Fax
(313) 874-9515
NPI assigned
Oct 18, 2012
Last updated
Apr 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2023

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 1052645 MI Primary

Addresses

Primary practice location

39450 W 12 Mile Road
Diabetes Care Connections 3Rd Floor
Novi, MI 48377

Mailing address

39450 W 12 Mile Road
3Rd Floor Diabetes Care Connections
Novi, MI 48377
Phone (313) 574-2152

Other practice location 1

110 E 2nd St
Royal Oak, MI 48067-2694
Phone (313) 574-2152

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

LicenseStateTypeSpecialty
1052645MIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682121600000",
    "number": "1679826341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39450 W 12 MILE ROAD",
            "address_2": "3RD FLOOR DIABETES CARE CONNECTIONS",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "313-574-2152",
            "fax_number": "313-874-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39450 W 12 MILE ROAD",
            "address_2": "DIABETES CARE CONNECTIONS 3RD FLOOR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "313-574-2152",
            "fax_number": "313-874-9515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480672694",
            "country_code": "US",
            "telephone_number": "313-574-2152",
            "fax_number": "313-874-9515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "RDN, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "1052645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.