Active NPI
Manicia Doss
- Registered Dietitian
- Saint Louis, MO
National Provider Identifier
1720604945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2023049173
- Practice address
- 3301 Commonwealth Ave
Saint Louis, MO 63143-3505 - Phone
- (503) 380-0906
- NPI assigned
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 2023049173 | MO | Primary |
Addresses
Primary practice location
3301 Commonwealth Ave
Saint Louis, MO 63143-3505
Mailing address
3301 Commonwealth Ave
Saint Louis, MO 63143-3505
Phone (503) 380-0906
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 |
|---|---|---|---|
| 2023049173 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1592870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738281600000",
"number": "1720604945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 COMMONWEALTH AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631433505",
"telephone_number": "503-380-0906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 COMMONWEALTH AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631433505",
"telephone_number": "503-380-0906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOSS",
"first_name": "MANICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-23",
"last_updated": "2025-01-31",
"certification_date": "2025-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2023049173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.