Active NPI
Mary P Lillico, R.D. L.D.
- Registered Dietitian
- Amarillo, TX
National Provider Identifier
1396865929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT02437
- Practice address
- 5413 River Rd
Amarillo, TX 79108-4607 - Phone
- (806) 381-4322
- Fax
- (806) 381-4322
- NPI assigned
- Mar 29, 2007
- Last updated
- Jul 9, 2007
- 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 | DT02437 | TX | Primary |
Addresses
Primary practice location
5413 River Rd
Amarillo, TX 79108-4607
Mailing address
5413 River Rd
Amarillo, TX 79108-4607
Phone (806) 381-4322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8K8622 | Other | TX | LINK TO 00BF18 |
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 |
|---|---|---|---|
| DT02437 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1396865929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5413 RIVER RD",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791084607",
"telephone_number": "806-381-4322",
"fax_number": "806-381-4322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5413 RIVER RD",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791084607",
"telephone_number": "806-381-4322",
"fax_number": "806-381-4322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLICO",
"first_name": "MARY",
"middle_name": "P",
"name_prefix": "Ms.",
"credential": "R.D. L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT02437",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LINK TO 00BF18",
"identifier": "8K8622",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
- Robert Howard Lewis Jr., LPC
- Tingting Li, LPC
- Liberty County Hospital District No. 1 (Five Points Nursing and Rehabilitation)
- Stevi Nicole Lichtie, MS, CCC-SLP
- Jennifer Licon, FNP-C
- Ju Hee Lim, DDS
- Melissa-Ann Elizabeth Limmer-Riola
- Lincare Inc
- Suzanne Lindmeier, PHARMD, RPH
- Allison Renae Lindsey, PT, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.