Active NPI
Mary Lynne Hixson, RD
- Registered Dietitian
- Providence, RI
National Provider Identifier
1124297775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN00107
- Practice address
- One Hoppin St.
Coro Center, 3Rd Floor
Providence, RI 02903 - Phone
- (401) 793-8790
- Fax
- (401) 793-8709
- NPI assigned
- Feb 28, 2008
- 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 | LDN00107 | RI | Primary |
Addresses
Primary practice location
One Hoppin St.
Coro Center, 3Rd Floor
Providence, RI 02903
Mailing address
PO Box 3238
Boston, MA 02241
Phone (866) 689-8862
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
| License | State | Type | Specialty |
|---|---|---|---|
| LDN00107 | RI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238025600000",
"number": "1124297775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3238",
"city": "BOSTON",
"state": "MA",
"postal_code": "02241",
"telephone_number": "866-689-8862",
"fax_number": "207-347-7401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE HOPPIN ST.",
"address_2": "CORO CENTER, 3RD FLOOR",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02903",
"telephone_number": "401-793-8790",
"fax_number": "401-793-8709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIXSON",
"first_name": "MARY",
"middle_name": "LYNNE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-28",
"last_updated": "2009-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "RI",
"license": "LDN00107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.