Active NPI
Miranda Reagan, MS, RD, LD
- Registered Dietitian
- Fort Worth, TX
National Provider Identifier
1780106211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT84129
- Practice address
- 900 8TH Ave
Fort Worth, TX 76104-3902 - Phone
- (817) 347-1980
- NPI assigned
- Jul 17, 2017
- 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 | DT84129 | TX | Primary |
Addresses
Primary practice location
900 8TH Ave
Fort Worth, TX 76104-3902
Mailing address
900 8TH Ave
Fort Worth, TX 76104-3902
Phone (817) 347-1980
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 |
|---|---|---|---|
| DT84129 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | 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": "1500249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1780106211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 8TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761043902",
"telephone_number": "817-347-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 8TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761043902",
"telephone_number": "817-347-1980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAGAN",
"first_name": "MIRANDA",
"credential": "MS, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-17",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT84129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.