Active NPI
Miriam K. Hendricks, R.D.
- Registered Dietitian
- Greenville, SC
National Provider Identifier
1962548057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 537217
- Practice address
- 875 W Faris Rd
Greenville, SC 29605-4254 - Phone
- (864) 455-4003
- NPI assigned
- Jan 29, 2007
- Sex
- Female
- 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 | 537217 | SC | Primary |
Addresses
Primary practice location
875 W Faris Rd
Greenville, SC 29605-4254
Mailing address
255 Enterprise Blvd
Suite 250
Greenville, SC 29615-6300
Phone (864) 454-0888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00021522 | Other | SC | MEDICARE RAILROAD ID |
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 |
|---|---|---|---|
| 537217 | SC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenville Health System | Past | Accepting new patients | |
| Greenville Health System | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Simpsonville, SC
- NPI 1558311779
-
- General Acute Care Hospital
- Simpsonville, SC
- NPI 1679992838
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962548057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 ENTERPRISE BLVD",
"address_2": "SUITE 250",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296156300",
"telephone_number": "864-454-0888",
"fax_number": "864-454-1130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 W FARIS RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054254",
"telephone_number": "864-455-4003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "MIRIAM",
"middle_name": "K.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "537217",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD ID",
"identifier": "P00021522",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.