Active NPI
Dawn Michelli Riccitelli, MS,RD,LDN
- Registered Dietitian
- Ft Walton BCH, FL
National Provider Identifier
1730334889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND5252
- Practice address
- 1000 Mar Walt Dr
Ft Walton BCH, FL 32547-6708 - Phone
- (850) 862-1111
- NPI assigned
- Nov 17, 2008
- 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 | ND5252 | FL | Primary |
Addresses
Primary practice location
1000 Mar Walt Dr
Ft Walton BCH, FL 32547-6708
Mailing address
307 Ridgewood Ave
Mary Esther, FL 32569-2711
Phone (850) 685-4187
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND5252 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226880000000",
"number": "1730334889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 RIDGEWOOD AVE",
"city": "MARY ESTHER",
"state": "FL",
"postal_code": "325692711",
"telephone_number": "850-685-4187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MAR WALT DR",
"city": "FT WALTON BCH",
"state": "FL",
"postal_code": "325476708",
"telephone_number": "850-862-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICCITELLI",
"first_name": "DAWN",
"middle_name": "MICHELLI",
"name_prefix": "Ms.",
"credential": "MS,RD,LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-17",
"last_updated": "2008-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND5252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Walton BCH, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.