Active NPI
Kayla Mariner
- Registered Dietitian
- Roanoke, VA
National Provider Identifier
1306187257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1080122
- Practice address
- 1030 S Jefferson St Ste G101
Roanoke, VA 24016-4418 - Phone
- (540) 224-4360
- Fax
- (540) 224-4357
- NPI assigned
- Mar 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1080122 | VA | Primary |
Addresses
Primary practice location
1030 S Jefferson St Ste G101
Roanoke, VA 24016-4418
Mailing address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Roanoke, VA
- NPI 1730123472
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1306187257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 S JEFFERSON ST STE 1006",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240111713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 S JEFFERSON ST STE G101",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240164418",
"telephone_number": "540-224-4360",
"fax_number": "540-224-4357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINER",
"first_name": "KAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-01",
"last_updated": "2023-10-12",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "VA",
"license": "1080122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.