Casey Mast Wallner, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LDD10158382 Issued in OR

Practice address

5280 NE Shell World PL
Newport, OR 97365-1246

Phone

(541) 579-1823

NPI assigned

Apr 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Casey Lynn Mast Former name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Your Friendly Dietitian, LLC

  • Registered Dietitian
  • Newport, OR
  • NPI 1871264424

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1104246024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5280 NE SHELL WORLD PL",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973651246",
            "telephone_number": "541-579-1823",
            "fax_number": "541-833-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5280 NE SHELL WORLD PL",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973651246",
            "telephone_number": "541-579-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLNER",
        "first_name": "CASEY",
        "middle_name": "MAST",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LDD10158382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "MAST",
            "middle_name": "LYNN",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Jo Anne Vogel, RN
• Lesa Wagner, MTD
• Walden Project, LLC
• Walgreen Co
• Liza Walker, LMT
• Walmart Inc.
• James Raymond Warren, B.S.
• Watkins Internal Medicine, LLC
• John F. Watkins, PHD, M.D.
• Hannah Renee Watson

• Registered Dietitian in Newport, OR
• Providers in Newport, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.