Active NPI
Michelle M Detwiler, RD, LD
- Registered Dietitian
- Marysville, OH
National Provider Identifier
1871831966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3607
- Practice address
- 11471 Watkins Rd
Marysville, OH 43040-8708 - Phone
- (937) 243-0635
- NPI assigned
- Jan 23, 2013
- 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 | 3607 | OH | Primary |
Addresses
Primary practice location
11471 Watkins Rd
Marysville, OH 43040-8708
Mailing address
11471 Watkins Rd
Marysville, OH 43040-8708
Phone (937) 243-0635
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 |
|---|---|---|---|
| 3607 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358899200000",
"number": "1871831966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11471 WATKINS RD",
"city": "MARYSVILLE",
"state": "OH",
"postal_code": "430408708",
"telephone_number": "937-243-0635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11471 WATKINS RD",
"city": "MARYSVILLE",
"state": "OH",
"postal_code": "430408708",
"telephone_number": "937-243-0635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETWILER",
"first_name": "MICHELLE",
"middle_name": "M",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-23",
"last_updated": "2013-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "3607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.