Individual provider Active NPI

Heba Mountaser, RD,LD

  • Registered Dietitian
  • Fort Worth, TX
National Provider Identifier
1295446193
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86171843 Issued in TX
Practice address
12105 Walden Wood Dr
Fort Worth, TX 76244-5573
Phone
(507) 202-8376
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT87578 TX
Registered Dietitian 133V00000X 86171843 TX Primary

Addresses

Primary practice location

12105 Walden Wood Dr
Fort Worth, TX 76244-5573

Mailing address

12105 Walden Wood Dr
Fort Worth, TX 76244-5573
Phone (507) 202-8376

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

LicenseStateTypeSpecialty
86171843TXMDRegistered Dietitian
DT87578TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrilicious Counseling Services LLC Dietitian, Registered CurrentSince Jan 29, 2023 Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1295446193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 WALDEN WOOD DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445573",
            "telephone_number": "507-202-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 WALDEN WOOD DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445573",
            "telephone_number": "507-202-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNTASER",
        "first_name": "HEBA",
        "credential": "RD,LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT87578",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86171843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.