OrganizationActive
Michiana Nutrition and Diabetes Education LLC
NPI 1619604410 · Health Service Clinic/Center · South Bend, IN
Provider details
- NPI number
- 1619604410
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Anouk Shelton, Registered Dietitian(815) 342-6205
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
300 S Saint Louis Blvd
South Bend, IN 46617-3043
Phone: (574) 301-5205
Fax: (574) 301-5205
Street-level locationGet directions
Mailing address
16151 Petro Dr
Mishawaka, IN 46544-6422
Registry dates
- Enumerated
- 2022-08-02
- Last updated
- 2022-10-25
- Certified
- 2022-10-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.