Individual provider Active NPI

Mary Eileen Sheehan, RD, CSP, LD

  • Pediatric Nutrition Registered Dietitian
  • Columbus, OH
National Provider Identifier
1053744151
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
LD7206 Issued in OH
Practice address
1920 Merganser Run Dr
Columbus, OH 43215-7018
Phone
(814) 242-8027
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X LD7206 OH Primary
Pediatric Nutrition Registered Dietitian 133VN1004X DX2861 MD

Addresses

Primary practice location

1920 Merganser Run Dr
Columbus, OH 43215-7018

Mailing address

1920 Merganser Run Dr
Columbus, OH 43215-7018
Phone (814) 242-8027

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

LicenseStateTypeSpecialty
DX2861MDMDPediatric Nutrition Registered Dietitian
LD7206OHMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1053744151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 MERGANSER RUN DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157018",
            "telephone_number": "814-242-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 MERGANSER RUN DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157018",
            "telephone_number": "814-242-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "MARY",
        "middle_name": "EILEEN",
        "credential": "RD, CSP, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "OH",
            "license": "LD7206",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "MD",
            "license": "DX2861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.