Active NPI
Abigail Debera Hallmark, MS, RDN, LDN
- Registered Dietitian
- Saint Louis, MO
National Provider Identifier
1043836315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2019029413
- Practice address
- 3510 Wyoming St Apt a
Saint Louis, MO 63118-2021 - Phone
- (814) 860-0291
- NPI assigned
- Jun 22, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2019029413 | MO | Primary |
Addresses
Primary practice location
3510 Wyoming St Apt a
Saint Louis, MO 63118-2021
Mailing address
3510 Wyoming St Apt a
Saint Louis, MO 63118-2021
Phone (814) 860-0291
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019029413 | MO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592784000000",
"number": "1043836315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3510 WYOMING ST APT A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631182021",
"telephone_number": "814-860-0291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3510 WYOMING ST APT A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631182021",
"telephone_number": "814-860-0291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLMARK",
"first_name": "ABIGAIL",
"middle_name": "DEBERA",
"credential": "MS, RDN, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-22",
"last_updated": "2020-06-22",
"certification_date": "2020-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2019029413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.