Active NPI
Mary Koch
- Registered Dietitian
- Fallon, NV
National Provider Identifier
1164848115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 32648-DI-2
- Practice address
- 801 E Williams Ave
Fallon, NV 89406 - Phone
- (775) 867-7086
- NPI assigned
- Mar 14, 2014
- Last updated
- May 30, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 32648-DI-2 | NV | Primary |
Addresses
Primary practice location
801 E Williams Ave
Fallon, NV 89406
Mailing address
801 E Williams Ave
Fallon, NV 89406-3052
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 |
|---|---|---|---|
| 32648-DI-2 | NV | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527638400000",
"number": "1164848115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 E WILLIAMS AVE",
"city": "FALLON",
"state": "NV",
"postal_code": "894063052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 E WILLIAMS AVE",
"city": "FALLON",
"state": "NV",
"postal_code": "89406",
"telephone_number": "775-867-7086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-14",
"last_updated": "2018-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "32648-DI-2",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fallon, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.