Active NPI
Mary Rose Shiner, MS, RDN/LD
- Registered Dietitian
- Rowlett, TX
National Provider Identifier
1205682747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT06490
- Practice address
- 7600 Lakeview Pkwy
Rowlett, TX 75088-4384 - Phone
- (972) 412-1631
- NPI assigned
- Apr 25, 2024
- Last updated
- Apr 25, 2024
- 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 | DT06490 | TX | Primary |
Addresses
Primary practice location
7600 Lakeview Pkwy
Rowlett, TX 75088-4384
Mailing address
331 Montana TRL
Murphy, TX 75094-3684
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT06490 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1205682747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 MONTANA TRL",
"city": "MURPHY",
"state": "TX",
"postal_code": "750943684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 LAKEVIEW PKWY",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750884384",
"telephone_number": "972-412-1631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHINER",
"first_name": "MARY",
"middle_name": "ROSE",
"credential": "MS, RDN/LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-25",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT06490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rowlett, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.