Active NPI
Andrea Nichole McGrew, RDN/LD
- Registered Dietitian
- Gulfport, MS
National Provider Identifier
1982925475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-2179
- Practice address
- 15542 Old Oak CT
Gulfport, MS 39503-9096 - Phone
- (417) 825-8847
- NPI assigned
- Jun 18, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2010001121 | MO | |
| Registered Dietitian | 133V00000X | D-2179 | MS | Primary |
Addresses
Primary practice location
15542 Old Oak CT
Gulfport, MS 39503-9096
Mailing address
15542 Old Oak CT
Gulfport, MS 39503-9096
Phone (417) 825-8847
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133V00000X | Medicaid | MO |
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 |
|---|---|---|---|
| 2010001121 | MO | MD | Registered Dietitian |
| D-2179 | MS | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1982925475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15542 OLD OAK CT",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395039096",
"telephone_number": "417-825-8847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15542 OLD OAK CT",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395039096",
"telephone_number": "417-825-8847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGREW",
"first_name": "ANDREA",
"middle_name": "NICHOLE",
"name_prefix": "Ms.",
"credential": "RDN/LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-18",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2010001121",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MS",
"license": "D-2179",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133V00000X",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.