Individual provider Active NPI

Megan Donnelly, RD

  • Registered Dietitian
  • Idaho Falls, ID
National Provider Identifier
1841780731
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1045452 Issued in ID
Practice address
2990 Cortez Ave
Idaho Falls, ID 83404
Phone
(208) 535-0440
Fax
(208) 535-0550
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1045452 ID Primary

Addresses

Primary practice location

2990 Cortez Ave
Idaho Falls, ID 83404

Mailing address

2990 Cortez Ave
Idaho Falls, ID 83404-7554
Phone (208) 535-0440

Other identifiers 1

IdentifierTypeStateIssuer
1045452OtherIDREGISTERED DIETICIAN

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

State licenses

LicenseStateTypeSpecialty
1045452IDMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1841780731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 CORTEZ AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047554",
            "telephone_number": "208-535-0440",
            "fax_number": "208-535-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 CORTEZ AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-535-0440",
            "fax_number": "208-535-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "MEGAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "1045452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETICIAN",
            "identifier": "1045452",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.