Active NPI
Tamara A. Marini, RD
- Registered Dietitian
- Racine, WI
National Provider Identifier
1386884773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1870-29
- Practice address
- 3801 Spring St
Racine, WI 53405-1667 - Phone
- (262) 687-4480
- NPI assigned
- Feb 25, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1870-29 | WI | Primary |
Addresses
Primary practice location
3801 Spring St
Racine, WI 53405-1667
Mailing address
3801 Spring St
Racine, WI 53405-1667
Phone (262) 687-4480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1870-29 | Other | WI | STATE LICENSE |
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 |
|---|---|---|---|
| 1870-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235520000000",
"number": "1386884773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 SPRING ST",
"city": "RACINE",
"state": "WI",
"postal_code": "534051667",
"telephone_number": "262-687-4480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 SPRING ST",
"city": "RACINE",
"state": "WI",
"postal_code": "534051667",
"telephone_number": "262-687-4480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINI",
"first_name": "TAMARA",
"middle_name": "A.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-25",
"last_updated": "2009-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "1870-29",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1870-29",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.