Michelle Brennan, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

082307 Issued in IA

Practice address

210 4TH Ave
Grinnell, IA 50112-1898

Phone

(641) 236-2488

Fax

(641) 236-2044

NPI assigned

Jul 30, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michelle Ethington Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1740536614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501121898",
            "telephone_number": "641-236-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501121898",
            "telephone_number": "641-236-2488",
            "fax_number": "641-236-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "MICHELLE",
        "credential": "RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "082307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0169129",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ETHINGTON",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katelyn Sue Beyer, PA
• Haley Bird, OTDR/L
• Eman Boulis, MD
• Jacob Daniel Boyer, PA-C
• Darius Kemar Bradford, DC
• Jody Marie Brink, D.C.
• Brian James Brown, D.C.
• Jana R Brown, LISW
• Brittany Ann Michelle Buckner, MSN, RN, FNP-BC
• Sharon Kaylene Burke, OTDR/L, CLT

• Registered Dietitian in Grinnell, IA
• Providers in Grinnell, IA by specialty
• Registered Dietitian in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.