Individual provider Active NPI

Maggie L Vertalino, R.D., L.D., MPH

  • Registered Dietitian
  • Minneapolis, MN
National Provider Identifier
1730120130
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2393 Issued in MN
Practice address
410 Church St SE
Minneapolis, MN 55455-0222
Phone
(612) 625-8400
Fax
(612) 677-3321
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 2393 MN Primary

Addresses

Primary practice location

410 Church St SE
Minneapolis, MN 55455-0222

Mailing address

410 Church St SE
Minneapolis, MN 55455-0222
Phone (612) 625-8400

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
2393MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD PastSince Jul 1, 2013 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
Family Support Services Inc. PastSince Mar 3, 2024 Accepting new patients
Regents of the University of Minnesota Past Accepting new patients
Regents of the University of Minnesota Past Accepting new patients

Organizations & group practices 5

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1730120130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "612-625-8400",
            "fax_number": "612-677-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "612-625-8400",
            "fax_number": "612-677-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERTALINO",
        "first_name": "MAGGIE",
        "middle_name": "L",
        "credential": "R.D., L.D., MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.