Individual provider Active NPI

Michelle Renee McGovern, R.D.

  • Registered Dietitian
  • Cedar Rapids, IA
National Provider Identifier
1922336270
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
01195 Issued in IA
Practice address
402 10TH St SE
Suite 700
Cedar Rapids, IA 52403-2403
Phone
(319) 363-1284
NPI assigned
Nov 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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 01195 IA Primary

Addresses

Primary practice location

402 10TH St SE
Suite 700
Cedar Rapids, IA 52403-2403

Mailing address

402 10TH St SE
Suite 700
Cedar Rapids, IA 52403-2403
Phone (319) 363-1284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100521000833 IA Practitioner - Registered Dietitian Or Nutrition Professional 9032248596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1002 4TH Ave SE
Cedar Rapids, IA 52403-2405
Phone (319) 298-2200

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01195IAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Sep 13, 2015 Accepting new patients
Carepro Integrative Health Clinic, Inc. Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

523 E 5th St
Solon, IA 52333
Phone (319) 624-3492

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

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": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1922336270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 10TH ST SE",
            "address_2": "SUITE 700",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032403",
            "telephone_number": "319-363-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 10TH ST SE",
            "address_2": "SUITE 700",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032403",
            "telephone_number": "319-363-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "01195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.