Individual provider Active NPI

Malini Stewart, RDN

  • Registered Dietitian
  • Statesboro, GA
National Provider Identifier
1710452677
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
727003 Issued in NU
Practice address
23702 Hwy 80 E
Statesboro, GA 30461-0845
Phone
(912) 489-4090
Fax
(912) 764-8378
NPI assigned
Oct 8, 2018
Last updated
Oct 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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 727003 NU Primary

Addresses

Primary practice location

23702 Hwy 80 E
Statesboro, GA 30461-0845

Mailing address

23702 Hwy 80 E
Statesboro, GA 30461-0845
Phone (912) 489-4090

Other identifiers 2

IdentifierTypeStateIssuer
727003OtherCOMISSION ON DIETETIC REGISTRATION
LD004103OtherGAGEORGIA BOARD OF LICENSED DIETITIANS

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Care Center, PC PastSince Aug 1, 1992 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1710452677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23702 HWY 80 E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304610845",
            "telephone_number": "912-489-4090",
            "fax_number": "912-764-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23702 HWY 80 E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304610845",
            "telephone_number": "912-489-4090",
            "fax_number": "912-764-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MALINI",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "727003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMISSION ON DIETETIC REGISTRATION",
            "identifier": "727003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF LICENSED DIETITIANS",
            "identifier": "LD004103",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.