Active NPI
Marcia L Wallen, MS, RD, LMNT
- Registered Dietitian
- Lincoln, NE
National Provider Identifier
1235384082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 882
- Practice address
- 6001 Village Drive
Hy-Vee
Lincoln, NE 68516 - Phone
- (402) 421-2462
- Fax
- (402) 421-6517
- NPI assigned
- Nov 20, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 882 | NE | Primary |
| Registered Dietitian | 133V00000X | 355564 |
Addresses
Primary practice location
6001 Village Drive
Hy-Vee
Lincoln, NE 68516
Mailing address
6001 Village Drive
Hy-Vee
Lincoln, NE 68516
Phone (402) 421-2462
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 882 | NE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227139200000",
"number": "1235384082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6001 VILLAGE DRIVE",
"address_2": "HY-VEE",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68516",
"telephone_number": "402-421-2462",
"fax_number": "402-421-6517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6001 VILLAGE DRIVE",
"address_2": "HY-VEE",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68516",
"telephone_number": "402-421-2462",
"fax_number": "402-421-6517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLEN",
"first_name": "MARCIA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "MS, RD, LMNT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-20",
"last_updated": "2008-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NE",
"license": "882",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "355564",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.