Active NPI
Giordana Marie Koutavas, RDN, LDN
- Registered Dietitian
- Hudson, OH
National Provider Identifier
1891309530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 7936
- Practice address
- 1263 Haymarket Way
Hudson, OH 44236-4659 - Phone
- (248) 535-6073
- NPI assigned
- Sep 1, 2020
- 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 | 7936 | OH | Primary |
Addresses
Primary practice location
1263 Haymarket Way
Hudson, OH 44236-4659
Mailing address
1263 Haymarket Way
Hudson, OH 44236-4659
Phone (248) 535-6073
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7936 | OH | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1891309530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1263 HAYMARKET WAY",
"city": "HUDSON",
"state": "OH",
"postal_code": "442364659",
"telephone_number": "248-535-6073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1263 HAYMARKET WAY",
"city": "HUDSON",
"state": "OH",
"postal_code": "442364659",
"telephone_number": "248-535-6073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUTAVAS",
"first_name": "GIORDANA",
"middle_name": "MARIE",
"credential": "RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-01",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "7936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hudson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.