Individual provider Active NPI

Kara Mickle, MS, RD/LD

  • Registered Dietitian
  • Midwest City, OK
National Provider Identifier
1891367389
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2615 Issued in OK
Practice address
1117 Lynn Fry Blvd
Midwest City, OK 73130-6023
Phone
(405) 615-0738
NPI assigned
Jul 14, 2021
Last updated
Jul 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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 2615 OK Primary

Addresses

Primary practice location

1117 Lynn Fry Blvd
Midwest City, OK 73130-6023

Mailing address

1117 Lynn Fry Blvd
Midwest City, OK 73130-6023

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
2615OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1891367389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 LYNN FRY BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 LYNN FRY BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306023",
            "telephone_number": "405-615-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLE",
        "first_name": "KARA",
        "credential": "MS, RD/LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.