Active NPI
Mary P Fierce, NBC-HWC
- Health & Wellness Coach
- Springfield, IL
National Provider Identifier
1124891148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- A-3369510
- Practice address
- 151 Genoa Dr
Springfield, IL 62703-5705 - Phone
- (503) 330-7931
- NPI assigned
- Nov 1, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | A-3369510 | IL | |
| Health & Wellness Coach | 171400000X | A-3369510 | Primary |
Addresses
Primary practice location
151 Genoa Dr
Springfield, IL 62703-5705
Mailing address
151 Genoa Dr
Springfield, IL 62703-5705
Phone (503) 330-7931
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
| License | State | Type | Specialty |
|---|---|---|---|
| A-3369510 | IL | MD | Health & Wellness Coach |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698796800000",
"number": "1124891148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 GENOA DR",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627035705",
"telephone_number": "503-330-7931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 GENOA DR",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627035705",
"telephone_number": "503-330-7931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIERCE",
"first_name": "MARY",
"middle_name": "P",
"credential": "NBC-HWC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-01",
"last_updated": "2023-11-01",
"certification_date": "2023-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "IL",
"license": "A-3369510",
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": "A-3369510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.