Mary Wissmann, MS, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2007000392 Issued in MO

Practice address

230 S Bemiston Ave Ste 430
Clayton, MO 63105-1907

Phone

(314) 874-3251

NPI assigned

Jan 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• McDaniel Nutrition Therapy, LLC

  • Registered Dietitian
  • Saint Louis, MO
  • NPI 1760022677

  Dietitian, Registered

  NPD

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1184255002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 DUNWOODY CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631221741",
            "telephone_number": "314-874-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S BEMISTON AVE STE 430",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051907",
            "telephone_number": "314-874-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSMANN",
        "first_name": "MARY",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2007000392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peyton Williams
• Stacy Williams, CP
• Takeira Williams, RN
• Willow Creek Counseling LLC
• Austin Wilmot, M.S.W., L.C.S.W.
• Lynn Wolfe, LPC
• Roxann Nicole Wombacher
• Womenscare Gynecology Inc
• Bridget A Woodfork
• Jameca Woody Cooper, PHD

• Registered Dietitian in Clayton, MO
• Providers in Clayton, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.