Active NPI
Mary Ellen Vivrett, R.D., L.D.
- Nutrition Education Nutritionist
- Beaumont, TX
National Provider Identifier
1356773683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Education Nutritionist
- License
- 16160
- Practice address
- 3725 Long Ave
Beaumont, TX 77706-4728 - Phone
- (409) 651-3489
- Fax
- (409) 898-0448
- NPI assigned
- Aug 9, 2013
- Last updated
- Jul 1, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | DT02946 | TX | |
| Nutrition Education Nutritionist | 133NN1002X | 16160 | TX | Primary |
Addresses
Primary practice location
3725 Long Ave
Beaumont, TX 77706-4728
Mailing address
3725 Long Ave
Beaumont, TX 77706-4728
Phone (409) 651-3489
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16160 | Other | TX | REGISTERED DIETITIAN |
| DT02946 | Other | TX | LICENSED DIETITIAN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16160 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Solutions | Past | Accepting new patients |
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.
-
- Registered Dietitian
- Beaumont, TX
- NPI 1235583873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1356773683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3725 LONG AVE",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777064728",
"telephone_number": "409-651-3489",
"fax_number": "409-899-0448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3725 LONG AVE",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777064728",
"telephone_number": "409-651-3489",
"fax_number": "409-898-0448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIVRETT",
"first_name": "MARY",
"middle_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "R.D., L.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-09",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "TX",
"license": "DT02946",
"primary": false
},
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "TX",
"license": "16160",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DIETITIAN",
"identifier": "16160",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED DIETITIAN",
"identifier": "DT02946",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.