Active NPI
Monica J. McCorkle, MS, RD, CDE
- Registered Dietitian
- San Diego, CA
National Provider Identifier
1831237734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 703180
- Practice address
- 2630 1St Ave
San Diego, CA 92103-6599 - Phone
- (619) 234-2158
- Fax
- (619) 234-2348
- NPI assigned
- Feb 2, 2007
- 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 | 703180 | CA | Primary |
Addresses
Primary practice location
2630 1St Ave
San Diego, CA 92103-6599
Mailing address
8065 Drexel CT
Lemon Grove, CA 91945-4202
Phone (619) 463-6249
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250528001667 | PA | Practitioner - Registered Dietitian Or Nutrition Professional | 6305029612 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
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": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1831237734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8065 DREXEL CT",
"city": "LEMON GROVE",
"state": "CA",
"postal_code": "919454202",
"telephone_number": "619-463-6249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2630 1ST AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921036599",
"telephone_number": "619-234-2158",
"fax_number": "619-234-2348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORKLE",
"first_name": "MONICA",
"middle_name": "J.",
"credential": "MS, RD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "703180",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.