Individual provider Active NPI

Mary Elzner

  • Registered Dietitian
  • Corpus Christi, TX
National Provider Identifier
1104234152
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT83015 Issued in TX
Practice address
10646 Veda Dr
Corpus Christi, TX 78410-2310
Phone
(361) 688-0188
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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 DT83015 TX Primary

Addresses

Primary practice location

10646 Veda Dr
Corpus Christi, TX 78410-2310

Mailing address

10646 Veda Dr
Corpus Christi, TX 78410-2310
Phone (361) 688-0188

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT83015TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1104234152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10646 VEDA DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784102310",
            "telephone_number": "361-688-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10646 VEDA DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784102310",
            "telephone_number": "361-688-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELZNER",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT83015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.