Active NPI
Kellie Hallaron, RDN
- Registered Dietitian
- Ann Arbor, MI
National Provider Identifier
1891352571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 15707
- Practice address
- 101 W. Liberty Street, Suite 360
Suite 360
Ann Arbor, MI 48104-4810 - Phone
- (248) 444-2164
- NPI assigned
- May 29, 2019
- 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 | 15707 | MI | Primary |
Addresses
Primary practice location
101 W. Liberty Street, Suite 360
Suite 360
Ann Arbor, MI 48104-4810
Mailing address
30361 Balfour Drive
Novi, MI 48377
Phone (248) 444-2164
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15707 | Other | MI | ACADEMY OF NUTRITION AND DIETETICS |
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 |
|---|---|---|---|
| 15707 | MI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1891352571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30361 BALFOUR DRIVE",
"city": "NOVI",
"state": "MI",
"postal_code": "48377",
"telephone_number": "248-444-2164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W. LIBERTY STREET, SUITE 360",
"address_2": "SUITE 360",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481044810",
"telephone_number": "248-444-2164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLARON",
"first_name": "KELLIE",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-29",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "15707",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACADEMY OF NUTRITION AND DIETETICS",
"identifier": "15707",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.