Mary Darlene Smith

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.002899 Issued in IL

Practice address

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718

Phone

(618) 253-7671

Fax

(618) 253-7104

NPI assigned

Jan 14, 2020

Last updated

Jan 14, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1295375541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 RED ROW",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595320",
            "telephone_number": "618-579-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DR WARREN TUTTLE DR",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462718",
            "telephone_number": "618-253-7671",
            "fax_number": "618-253-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "DARLENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.002899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msmith@harrisburgmc.com",
            "affiliation": "N",
            "address_1": "100 Dr Warren Tuttle Dr",
            "city": "Harrisburg",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629462718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandy Shortland
• Linda K Sims
• Billy G Smith
• Charli Walter Leroy Smith Jr., M.D.
• Kimberly Dawn Smith
• Patricia Smith, MD
• Pennie Lowanda Smith, PA
• Southeastern Residential Alternatives, Inc.
• Southern Illinois Hospital Services (Herrin Hospital)
• Southern Illinois Hospital Services (Herrin Hospital)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.