Active NPI
Ofelia Bayutas Mutia, RD
- Registered Dietitian
- Lawrenceville, GA
National Provider Identifier
1710909809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD002082
- Practice address
- 965 Duluth Hwy Ste 101
Lawrenceville, GA 30043-7316 - Phone
- (678) 683-2786
- Fax
- (678) 683-2786
- NPI assigned
- Jul 24, 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 | LD002082 | GA | Primary |
Addresses
Primary practice location
965 Duluth Hwy Ste 101
Lawrenceville, GA 30043-7316
Mailing address
965 Duluth Hwy Ste 101
Lawrenceville, GA 30043-7316
Phone (678) 683-2786
Other names 1
- Mrs. Ofelia Mutia Milligan
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
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": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421625600000",
"number": "1710909809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "965 DULUTH HWY STE 101",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300437316",
"telephone_number": "678-683-2786",
"fax_number": "678-683-2786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 DULUTH HWY STE 101",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300437316",
"telephone_number": "678-683-2786",
"fax_number": "678-683-2786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTIA",
"first_name": "OFELIA",
"middle_name": "BAYUTAS",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2015-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD002082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "OFELIA",
"last_name": "MILLIGAN",
"middle_name": "MUTIA",
"prefix": "MRS.",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.