Active NPI
Mary Monroe, RDN, LD, IBCLC
- Registered Dietitian
- Hayden, ID
National Provider Identifier
1376335737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-363
- Practice address
- 8500 N Atlas Rd
Hayden, ID 83835-8332 - Phone
- (208) 415-5136
- Fax
- (208) 415-5131
- NPI assigned
- May 21, 2025
- Last updated
- Jun 18, 2025
- 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 |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-304099 | ||
| Registered Dietitian | 133V00000X | D-363 | ID | Primary |
Addresses
Primary practice location
8500 N Atlas Rd
Hayden, ID 83835-8332
Mailing address
8500 N Atlas Rd
Hayden, ID 83835-8332
Phone (208) 415-5136
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-363 | ID | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750204800000",
"number": "1376335737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8500 N ATLAS RD",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838358332",
"telephone_number": "208-415-5136",
"fax_number": "208-415-5131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 N ATLAS RD",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838358332",
"telephone_number": "208-415-5136",
"fax_number": "208-415-5131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONROE",
"first_name": "MARY",
"credential": "RDN, LD, IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-21",
"last_updated": "2025-06-18",
"certification_date": "2025-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": "L-304099",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "D-363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayden, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.