Marya Dawn Willie, LRD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2280 Issued in MN

Practice address

705 Pleasant Ave S
Essentia Health Park Rapids Clinic
Park Rapids, MN 56470-1440

Phone

(218) 732-2800

Fax

(218) 732-2857

NPI assigned

Jun 9, 2006

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

Other identifiers 6

Other names 1

• Marya D Kadow Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• St Marys Regional Health Center

  dba Essentia Health Park Rapids Hwy 34 Clinic

  • Multi-Specialty Clinic/Center
  • Park Rapids, MN
  • NPI 1730731464
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1306887393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST THIRD STREET",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558001951",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PLEASANT AVE S",
            "address_2": "ESSENTIA HEALTH PARK RAPIDS CLINIC",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701440",
            "telephone_number": "218-732-2800",
            "fax_number": "218-732-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIE",
        "first_name": "MARYA",
        "middle_name": "DAWN",
        "credential": "LRD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LHS/BANNERHEALTH #",
            "identifier": "34871",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "6300246",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "6300248",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "6300247",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS #",
            "identifier": "HP39460",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBS #",
            "identifier": "23627",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYA",
            "last_name": "KADOW",
            "middle_name": "D",
            "credential": "LRD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Harold Franklin Wellman, COUNSELOR
• Wellness Matters LLC
• Rhea Wenschlag, PA-C
• Margaret A West, PTA
• Murry D. Westberg, OD
• Amanda Sue Wollschlager, APRN, PMHNP-BC
• Rande Woodrum, MSW, LGSW
• Holly C Wright, APRN, CNP
• Robert L Wroblewski, MD
• Anthony J Yerkes, CRNA

• Registered Dietitian in Park Rapids, MN
• Providers in Park Rapids, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.