Active NPI
Mary Margaret Roberts, RD, LD
- Registered Dietitian
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT92370
- Practice address
- 1120 E Front St
Tyler, TX 75702-8414 - Phone
- (903) 606-3630
- Fax
- (903) 606-3660
- NPI assigned
- Aug 12, 2025
- Last updated
- Sep 17, 2026
- 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 | DT92370 | TX | Primary |
Addresses
Primary practice location
1120 E Front St
Tyler, TX 75702-8414
Mailing address
1120 E Front St
Tyler, TX 75702-8414
Phone (903) 606-3630
Other practice location 1
8934 S Broadway Ave Ste 448
Tyler, TX 75703-5475
Phone (903) 606-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1120 E Front St
Tyler, TX 75702-8414
2900 Saint Michael Dr
Suite 401
Texarkana, TX 75503-2343
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT92370 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Magella Medical Associates Billing, Inc. | Past | Accepting new patients |
Locations
1120 E Front St
Tyler, TX 75702
Phone (903) 606-3630
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Christus Trinity Clinic
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
dba Christus Trinity Clinic
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
dba Magella Medical Associates
- Neonatal-Perinatal Medicine Physician
- Round Rock, TX
- NPI 1083631071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789603200000",
"number": "1043196553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 E FRONT ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757028414",
"telephone_number": "903-606-3630",
"fax_number": "903-606-3660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 E FRONT ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757028414",
"telephone_number": "903-606-3630",
"fax_number": "903-606-3660"
}
],
"practiceLocations": [
{
"address_1": "8934 S Broadway Ave Ste 448",
"address_purpose": "LOCATION",
"city": "Tyler",
"state": "TX",
"postal_code": "757035475",
"country_code": "US",
"telephone_number": "903-606-5100",
"fax_number": "903-606-5105",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "MARY",
"middle_name": "MARGARET",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-12",
"last_updated": "2026-09-17",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT92370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.