Active NPI
Mia Elise Botkins, MPH, RD, LD
- Registered Dietitian
- Grove City, OH
National Provider Identifier
1851142962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD.10168
- Practice address
- 1901 Ohio Dr
Grove City, OH 43123-4835 - Phone
- (614) 864-7225
- NPI assigned
- Mar 27, 2024
- 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 | LD.10168 | OH | Primary |
Addresses
Primary practice location
1901 Ohio Dr
Grove City, OH 43123-4835
Mailing address
3347 La Coste LN
Columbus, OH 43228-7027
Phone (614) 377-3455
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
| License | State | Type | Specialty |
|---|---|---|---|
| LD.10168 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711497600000",
"number": "1851142962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3347 LA COSTE LN",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432287027",
"telephone_number": "614-377-3455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 OHIO DR",
"city": "GROVE CITY",
"state": "OH",
"postal_code": "431234835",
"telephone_number": "614-864-7225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTKINS",
"first_name": "MIA",
"middle_name": "ELISE",
"credential": "MPH, RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-27",
"last_updated": "2024-03-27",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "LD.10168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grove City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.