Crystal Riley, RD
Individual provider Active NPI Registered Dietitian · Hart, MI
NPI 1982109021 · NPPES record last updated Mar 29, 2018
Key facts
- NPI
- 1982109021
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 979463 (MI)
- Practice address
- 601 E Main St
Hart, MI 49420-1144 - Phone
- (231) 873-3577
- Fax
- (231) 873-3557
- NPI assigned
- Mar 29, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 979463 | MI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Michigan, LLC | Past |
Accepting new patients | |
| Lakeside Comprehensive Rehabilitation Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 979463 | MI | Yes |
Addresses
Primary practice location
601 E Main St
Hart, MI 49420-1144
Mailing address
601 E Main St
Hart, MI 49420-1144
Phone (231) 873-3577
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 979463 | Other | MI | REGISTERED DIETITIAN |
Other providers in Hart, MI
- Planned Parenthood Centers of West Mi
- Haley May Porter
- Amanda J Redeker
- English Holly Rex
- Kristie Lee Richards
- Dora Lee Rodriguez
- Marissa Royce
- Rural Home Care Services, Inc.
- Rybarz Vision Associates, PLLC
- Craig James Rybarz
All providers in Hart, MI · Registered Dietitian in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.