PAIGE NICOLE PHIZACKLEA RD - NPI 1285507699 - Dietitian, Registered in Grand Rapids, MI

Q: What is Paige Phizacklea's NPI number?

The NPI number for Paige Phizacklea is 1285507699. It was assigned to this individual provider in the NPPES registry on September 24, 2025.

Q: What is Paige Phizacklea's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Q: When was this NPI record last updated?

The NPPES record for Paige Phizacklea was last updated on September 24, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Paige Nicole Phizacklea Rd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAIGE NICOLE PHIZACKLEA RD (NPI 1285507699) is an individual dietitian, registered in Grand Rapids, Michigan and active in the NPI registry since September 2025. She is a graduate of Other (2011).

NPPES Registry Identity

NPI1285507699

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NamePAIGE NICOLE PHIZACKLEACredential: RD

Location Address100 MICHIGAN ST NE # MC845Grand Rapids, MI 49503-2560

Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560 · (616) 486-6790

Phone(616) 486-6790

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateSeptember 24, 2025

NPPES CertifiedSeptember 24, 2025

✔ NPI 1285507699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

100 MICHIGAN ST NE # MC845, Grand Rapids, MI 49503

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paige Nicole Phizacklea Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799277141

PECOS Enrollment IDI20251122001347

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSANDRA CUMMINGS DNP

Nurse Practitioner (Pediatrics)