Active NPI
Sarah Mellberg, RD
- Registered Dietitian
- Whiteriver, AZ
National Provider Identifier
1821773565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86148367
- Practice address
- 200 W Hospital Dr
Whiteriver, AZ 85941 - Phone
- (928) 338-4911
- NPI assigned
- Jun 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 86148367 | Primary |
Addresses
Primary practice location
200 W Hospital Dr
Whiteriver, AZ 85941
Mailing address
3134 Summer Dr
Lakeside, AZ 85929-6726
Phone (719) 660-5096
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS IHS Phoenix Area | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current | 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.
-
- Clinic/Center
- Cibecue, AZ
- NPI 1427335181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1821773565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3134 SUMMER DR",
"city": "LAKESIDE",
"state": "AZ",
"postal_code": "859296726",
"telephone_number": "719-660-5096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W HOSPITAL DR",
"city": "WHITERIVER",
"state": "AZ",
"postal_code": "85941",
"telephone_number": "928-338-4911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLBERG",
"first_name": "SARAH",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-20",
"last_updated": "2023-06-20",
"certification_date": "2023-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86148367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whiteriver, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.