Individual provider Active NPI

Cheryl C Marco, RD, CDE

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1407055486
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN001985 Issued in PA
Practice address
211 S 9TH St
Philadelphia, PA 19107-6810
Phone
(215) 955-1925
Fax
(215) 928-3160
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN001985 PA Primary

Addresses

Primary practice location

211 S 9TH St
Philadelphia, PA 19107-6810

Mailing address

615 Chestnut St
14TH Floor, Central Enrollment
Philadelphia, PA 19106-4404

Other identifiers 1

IdentifierTypeStateIssuer
007761098MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040116000769 PA Practitioner - Registered Dietitian Or Nutrition Professional 1759282296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

211 S 9TH St
Suite 600
Philadelphia, PA 19107-6810
Phone (215) 955-8430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Mar 30, 2009 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

211 S 9th St
Ste 600
Philadelphia, PA 19107
Phone (215) 955-1925

615 Chestnut St
Fl 14
Philadelphia, PA 19106
Phone (215) 955-1175

111 S 11th St
Ste 4240
Philadelphia, PA 19107
Phone (215) 955-6550

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1407055486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CHESTNUT ST",
            "address_2": "14TH FLOOR, CENTRAL ENROLLMENT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076810",
            "telephone_number": "215-955-1925",
            "fax_number": "215-928-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCO",
        "first_name": "CHERYL",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN001985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007761098",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.