Individual provider Active NPI

Maureen Shanahan Fauler, RD

  • Registered Dietitian
  • Liverpool, NY
National Provider Identifier
1093059263
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
7091514 Issued in NY
Practice address
7360 Farmstead Rd
Liverpool, NY 13088-4714
Phone
(315) 451-7792
NPI assigned
Nov 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 7091514 NY Primary

Addresses

Primary practice location

7360 Farmstead Rd
Liverpool, NY 13088-4714

Mailing address

7360 Farmstead Rd
Liverpool, NY 13088-4714
Phone (315) 451-7792

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
7091514NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1093059263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7360 FARMSTEAD RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884714",
            "telephone_number": "315-451-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7360 FARMSTEAD RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884714",
            "telephone_number": "315-451-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULER",
        "first_name": "MAUREEN",
        "middle_name": "SHANAHAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-12",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "7091514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; 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.