Individual provider Active NPI

Mary Miker, MS, RDN, LD

  • Registered Dietitian
  • Cleveland, OH
National Provider Identifier
1871924464
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
7142 Issued in OH
Practice address
10701 East Blvd
Cleveland, OH 44106-1702
Phone
(330) 602-5339
NPI assigned
Dec 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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 7142 OH Primary

Addresses

Primary practice location

10701 East Blvd
Cleveland, OH 44106-1702

Mailing address

6150 Oak Tree Blvd Ofc Suite
Independence, OH 44131-6917
Phone (216) 379-2619

Other practice location 1

6150 Oak Tree Blvd Ofc Suite
Independence, OH 44131-6917
Phone (216) 379-2619

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7142OHMDHealth Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1871924464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 OAK TREE BLVD OFC SUITE",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441316917",
            "telephone_number": "216-379-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "330-602-5339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6150 Oak Tree Blvd Ofc Suite",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "OH",
            "postal_code": "441316917",
            "country_code": "US",
            "telephone_number": "216-379-2619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKER",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "7142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.