Active NPI
Madhavi Latha Peddada, MS,RD,LDN
- Registered Dietitian
- Jupiter, FL
National Provider Identifier
1902981467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN0000001667
- Practice address
- 1645 Jeaga Dr
Jupiter, FL 33458-8718 - Phone
- (615) 346-9187
- NPI assigned
- Oct 25, 2006
- Last updated
- Dec 9, 2017
- 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 | LDN0000001667 | TN | Primary |
Addresses
Primary practice location
1645 Jeaga Dr
Jupiter, FL 33458-8718
Mailing address
1645 Jeaga Dr
Jupiter, FL 33458-8718
Phone (615) 346-9187
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
| License | State | Type | Specialty |
|---|---|---|---|
| LDN0000001667 | TN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mnutritioncoach LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512777600000",
"number": "1902981467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1645 JEAGA DR",
"city": "JUPITER",
"state": "FL",
"postal_code": "334588718",
"telephone_number": "615-346-9187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 JEAGA DR",
"city": "JUPITER",
"state": "FL",
"postal_code": "334588718",
"telephone_number": "615-346-9187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDDADA",
"first_name": "MADHAVI",
"middle_name": "LATHA",
"name_prefix": "Mrs.",
"credential": "MS,RD,LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2017-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "LDN0000001667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jupiter, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.