Marissa Madeira, MS, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

110 E Hines PL Apt 4A3
Peoria, IL 61614-7446

Phone

(808) 206-3983

NPI assigned

Nov 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Flower Marissa Madeira Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1265035968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E HINES PL APT 4A3",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616147446",
            "telephone_number": "808-206-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E HINES PL APT 4A3",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616147446",
            "telephone_number": "808-206-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADEIRA",
        "first_name": "MARISSA",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FLOWER MARISSA",
            "last_name": "MADEIRA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tristan Micheal Mackey, MD
• Paul Miles Macmahon, MD
• Gary R Macvicar, MD
• Kamlesh Samson Macwan, MD
• Katelynn Madden, APRN, CNS
• Kathryn J Madigan, RN, BSN, IBCLC
• Kaitlin Ann Madison, MSN, APN, FNP-C
• Susi Madrigal-Leon, FNP-C
• Steven J Mahany, DMD
• Jael K. Mahasi, NCC, LPC

• Registered Dietitian in Peoria, IL
• Providers in Peoria, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.