Individual provider Active NPI

Kelly Marie Marshall, MS, RD, CDCES, EP-C

  • Registered Dietitian
  • Honolulu, HI
National Provider Identifier
1295094662
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1062291
Practice address
1001 Bishop St Ste 2685a
Honolulu, HI 96813-3404
Phone
(808) 551-5302
Fax
(808) 490-0372
NPI assigned
May 4, 2012
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1062291 Primary

Addresses

Primary practice location

1001 Bishop St Ste 2685a
Honolulu, HI 96813-3404

Mailing address

1001 Bishop St Ste 2685a
Honolulu, HI 96813-3404
Phone (808) 551-5302

Other names 1

  • Mrs. Kelly Marie McDaniel Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260427001885 CA Practitioner - Registered Dietitian Or Nutrition Professional 3779809728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

350 Parnassus Ave
San Francisco, CA 94117-3649

PO Box
Phoenix, AZ 85072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Vascular Institute-Kona CurrentSince Feb 1, 2023 Accepting new patients
Lanai Community Health Center PastSince Mar 28, 2021 Accepting new patients

Locations

75-184 Hualalai Rd
Ste 100-101
Kailua Kona, HI 96740
Phone (805) 975-7463

210 Imi Kala St
Ste 102
Wailuku, HI 96793
Phone (808) 444-3477

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1295094662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BISHOP ST STE 2685A",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133404",
            "telephone_number": "808-551-5302",
            "fax_number": "808-490-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BISHOP ST STE 2685A",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133404",
            "telephone_number": "808-551-5302",
            "fax_number": "808-490-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MS, RD, CDCES, EP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2025-08-01",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1062291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MCDANIEL",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "MS, RD, CDE, HFS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.