Mallory Robertson, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1494 Issued in NH

Practice address

15 Old Rollinsford Rd Ste 105
Dover, NH 03820-2870

Phone

(603) 740-2647

NPI assigned

Feb 23, 2024

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 NH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wentworth Douglass Physician Corporation

  • Magnetic Resonance Imaging Radiologic Technologist
  • Dover, NH
  • NPI 1447352430

  Dietitian, Registered

  Medicare reassignment NPD
• Wentworth Douglass Physician Corporation

  • Diagnostic Radiology Physician
  • Somersworth, NH
  • NPI 1295326494
  NPD
• Wentworth Douglass Hospital

  • Pain Clinic/Center
  • Portsmouth, NH
  • NPI 1790416774
  NPD (past)

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1366208779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WASHINGTON ST APT 210",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203840",
            "telephone_number": "978-880-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OLD ROLLINSFORD RD STE 105",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202870",
            "telephone_number": "603-740-2647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "789 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "038202526",
            "country_code": "US",
            "telephone_number": "603-742-5252 x2957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MALLORY",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": "1494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Thomas Richard II, D.O.
• Hayley Langmaid Ringwood, MS
• Rite Aid of New Hampshire Inc
• Elisha Rivera
• Derreth C Roberts, ARNP
• Matthew Douglas Robertson, M.D.
• Holly Schaefer Robinson, LICSW
• Kellie Rocha, LICSW
• James Rochefort, DMD
• Evanthe Rockwood

• Registered Dietitian in Dover, NH
• Providers in Dover, NH by specialty
• Registered Dietitian in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.

Verify at the official NPI Registry.