Active NPI
Julie Domanski Mowery, R.D. L.D.
- Registered Dietitian
- St Louis Park, MN
National Provider Identifier
1831324003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1712
- Practice address
- 3525 Monterey Dr
St Louis Park, MN 55416 - Phone
- (952) 993-6200
- NPI assigned
- May 18, 2009
- Last updated
- Dec 22, 2009
- 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 | 1712 | MN | Primary |
Addresses
Primary practice location
3525 Monterey Dr
St Louis Park, MN 55416
Mailing address
11927 Germaine Ter
Eden Prairie, MN 55347-5280
Phone (952) 941-5831
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1712 | MN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261440000000",
"number": "1831324003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11927 GERMAINE TER",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553475280",
"telephone_number": "952-941-5831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 MONTEREY DR",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55416",
"telephone_number": "952-993-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOWERY",
"first_name": "JULIE",
"middle_name": "DOMANSKI",
"name_prefix": "Mrs.",
"credential": "R.D. L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-18",
"last_updated": "2009-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "1712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.