Mary Jo Novak Reeser, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT06556 Issued in TX

Practice address

605 S Conroe Medical Dr
Conroe, TX 77304-4722

Phone

(936) 539-4004

Fax

(936) 521-3964

NPI assigned

Dec 29, 2021

Last updated

Dec 29, 2021By 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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lone Star Community Health Center, IncGroup PAC ID 7416841994, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.jo.reeser.1@31617.direct.athenahealth.com

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.

• Lone Star Community Health Center, Inc.

  dba Lone Star Family Health Center

  • Family Medicine Physician
  • Conroe, TX
  • NPI 1568590610
  Medicare reassignment Care Compare group NPD
• Lone Star Community Health Center, Inc.

  dba Lone Star Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Magnolia, TX
  • NPI 1710857131
  NPD

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1295495430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-521-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESER",
        "first_name": "MARY JO",
        "middle_name": "NOVAK",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT06556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunil K Reddy, MD
• Redemptive Pathways, PLLC
• Redriver Clinical Diagnostics, LLC
• Alysha Danielle Reed, PTA, DPT
• Thomas M Reed, DPM,PA
• Ashlyn Anne Reeves, LPC
• Steven Michael Reeves
• Refuge Counseling Center LLC
• Merideth Regina, MSPT
• Regional Medical Concepts

• Registered Dietitian in Conroe, TX
• Providers in Conroe, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.