Individual provider Active NPI

Marisa Woodall Smith, RD

  • Registered Dietitian
  • Nashville, TN
National Provider Identifier
1316493083
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3119 Issued in TN
Practice address
615 Main St Ste M1
Nashville, TN 37206-3603
Phone
(615) 709-0903
Fax
(855) 634-2216
NPI assigned
Aug 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 167733 KY
Registered Dietitian 133V00000X LD006164 GA
Registered Dietitian 133V00000X 4093 AL
Registered Dietitian 133V00000X 3119 TN Primary

Addresses

Primary practice location

615 Main St Ste M1
Nashville, TN 37206-3603

Mailing address

615 Main St Ste M1
Nashville, TN 37206-3603
Phone (615) 709-0903

Other practice location 1

506 Neelys Bend Rd
Madison, TN 37115-4923
Phone (615) 943-8025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN, AL, GA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20161104002084 KY Practitioner - Registered Dietitian Or Nutrition Professional 4981982329
I20210914002174 TN Practitioner - Registered Dietitian Or Nutrition Professional 4981982329 Reassigns benefits to 1 organization
I20220713003850 AL Practitioner - Registered Dietitian Or Nutrition Professional 4981982329
I20220906000000 GA Practitioner - Registered Dietitian Or Nutrition Professional 4981982329

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dietitian Group LLCGroup PAC ID 5193161479, 4 clinicians

Practice addresses (Care Compare)

615 Main St
Suite M1
Nashville, TN 37206-3603
Phone (615) 709-0903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3119TNMDClinical Child & Adolescent Psychologist
LD006164GAMDRegistered Dietitian
4093ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dietitian Group, LLC Dietitian, Registered CurrentSince Feb 29, 2024 Accepting new patients

Locations

615 Main St
Ste M1
Nashville, TN 37206
Phone (615) 709-0903

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1316493083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MAIN ST STE M1",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372063603",
            "telephone_number": "615-709-0903",
            "fax_number": "855-634-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MAIN ST STE M1",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372063603",
            "telephone_number": "615-709-0903",
            "fax_number": "855-634-2216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Neelys Bend Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "TN",
            "postal_code": "371154923",
            "country_code": "US",
            "telephone_number": "615-943-8025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARISA",
        "middle_name": "WOODALL",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "167733",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD006164",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AL",
            "license": "4093",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "3119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.