Active NPI
Patrick Jackson McGavin Sr., RDN, LD
- Registered Dietitian
- Vestavia, AL
National Provider Identifier
1699205500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2748
- Practice address
- 3254 Valley Park PL
Vestavia, AL 35243-5110 - Phone
- (251) 802-9117
- NPI assigned
- Jun 13, 2017
- Sex
- Male
- 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 | 2748 | AL | Primary |
Addresses
Primary practice location
3254 Valley Park PL
Vestavia, AL 35243-5110
Mailing address
3254 Valley Park PL
Vestavia, AL 35243-5110
Phone (251) 802-9117
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2748 | AL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1699205500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3254 VALLEY PARK PL",
"city": "VESTAVIA",
"state": "AL",
"postal_code": "352435110",
"telephone_number": "251-802-9117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3254 VALLEY PARK PL",
"city": "VESTAVIA",
"state": "AL",
"postal_code": "352435110",
"telephone_number": "251-802-9117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGAVIN",
"first_name": "PATRICK",
"middle_name": "JACKSON",
"name_suffix": "Sr.",
"credential": "RDN, LD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-13",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AL",
"license": "2748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vestavia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.