Active NPI
Serene Mazhar, RD
- Registered Dietitian
- Phoenix, AZ
National Provider Identifier
1245771005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1017561
- Practice address
- 4041 N Central Ave
BLDG. C
Phoenix, AZ 85012-3330 - Phone
- (602) 279-5262
- NPI assigned
- Mar 13, 2017
- 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 | 1017561 | AZ | Primary |
Addresses
Primary practice location
4041 N Central Ave
BLDG. C
Phoenix, AZ 85012-3330
Mailing address
4041 N Central Ave
BLDG. C
Phoenix, AZ 85012-3330
Phone (602) 279-5262
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 |
|---|---|---|---|
| 1017561 | AZ | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489363200000",
"number": "1245771005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4041 N CENTRAL AVE",
"address_2": "BLDG. C",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850123330",
"telephone_number": "602-279-5262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4041 N CENTRAL AVE",
"address_2": "BLDG. C",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850123330",
"telephone_number": "602-279-5262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZHAR",
"first_name": "SERENE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-13",
"last_updated": "2017-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "1017561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.