Active NPI
Kristy Joy Quiros Mary, RDN, LD
- Registered Dietitian
- Tamuning, GU
National Provider Identifier
1255981502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- NUT-09
- Practice address
- 850 Gov. Carlos Camacho Road
Tamuning, GU 96913 - Phone
- (671) 647-2179
- NPI assigned
- Sep 18, 2019
- Last updated
- Sep 18, 2019
- 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 | NUT-09 | GU | Primary |
Addresses
Primary practice location
850 Gov. Carlos Camacho Road
Tamuning, GU 96913
Mailing address
PO Box 10595
Tamuning, GU 96931-0595
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 |
|---|---|---|---|
| NUT-09 | GU | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568764800000",
"number": "1255981502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10595",
"city": "TAMUNING",
"state": "GU",
"postal_code": "969310595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 GOV. CARLOS CAMACHO ROAD",
"city": "TAMUNING",
"state": "GU",
"postal_code": "96913",
"telephone_number": "671-647-2179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARY",
"first_name": "KRISTY JOY",
"middle_name": "QUIROS",
"credential": "RDN, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-18",
"last_updated": "2019-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GU",
"license": "NUT-09",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tamuning, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.