Organization Active NPI

Mary Churchman, LLC

  • Registered Dietitian
  • Plano, TX
National Provider Identifier
1205722907
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
MARY CHURCHMAN, LLC
Practice address
1400 Preston Rd Ste 400
Plano, TX 75093-5189
Phone
(972) 275-6144
NPI assigned
Jun 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Authorized official

Name
Mary Churchman, RDNPI 1457247751
Title
Owner
Phone
(972) 275-6144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

1400 Preston Rd Ste 400
Plano, TX 75093-5189

Mailing address

PO Box 251754
Plano, TX 75025-1517

Other names 1

  • Mary Churchman, RD, LDN Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250825002456 TX Part B Supplier - Clinic/Group Practice 3375043268 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1205722907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251754",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PRESTON RD STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935189",
            "telephone_number": "972-275-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY CHURCHMAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-08-04",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "CHURCHMAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-275-6144",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Churchman, RD, LDN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mary Churchman, RD, LDN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.