Active NPI
Michael L Fox, MS RDN LN
- Registered Dietitian
- Bozeman, MT
National Provider Identifier
1912374570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 42222
- Practice address
- 2100 Fairway Dr
Suite 100
Bozeman, MT 59715-5814 - Phone
- (406) 209-1696
- NPI assigned
- Aug 28, 2015
- Sex
- Male
- 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 | 42222 | MT | Primary |
Addresses
Primary practice location
2100 Fairway Dr
Suite 100
Bozeman, MT 59715-5814
Mailing address
2100 Fairway Dr
Suite 100
Bozeman, MT 59715-5814
Phone (406) 209-1696
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 |
|---|---|---|---|
| 42222 | MT | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440720000000",
"number": "1912374570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 FAIRWAY DR",
"address_2": "SUITE 100",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597155814",
"telephone_number": "406-209-1696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 FAIRWAY DR",
"address_2": "SUITE 100",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597155814",
"telephone_number": "406-209-1696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOX",
"first_name": "MICHAEL",
"middle_name": "L",
"credential": "MS RDN LN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-28",
"last_updated": "2015-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MT",
"license": "42222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.