Individual provider Active NPI

Marie Elizabeth Groves, MS, RD, CNSC, LD

  • Registered Dietitian
  • Dallas, TX
National Provider Identifier
1437343779
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT07645 Issued in TX
Practice address
17111 Preston Rd
Suite 100
Dallas, TX 75248-1229
Phone
(972) 754-7498
Fax
(210) 519-3000
NPI assigned
Aug 29, 2007
Last updated
Mar 31, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT07645 TX Primary
Pediatric Nutrition Registered Dietitian 133VN1004X DT07645 TX

Addresses

Primary practice location

17111 Preston Rd
Suite 100
Dallas, TX 75248-1229

Mailing address

668 Bryn Mahr LN
Rockwall, TX 75087-6018
Phone (972) 754-7498

Other identifiers 2

IdentifierTypeStateIssuer
DT07645OtherTXLICENSED DIETITIAN
895816OtherREGISTERD DIETIITIAN

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DT07645TXMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1437343779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 BRYN MAHR LN",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750876018",
            "telephone_number": "972-754-7498",
            "fax_number": "972-722-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17111 PRESTON RD",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481229",
            "telephone_number": "972-754-7498",
            "fax_number": "210-519-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVES",
        "first_name": "MARIE",
        "middle_name": "ELIZABETH",
        "credential": "MS, RD, CNSC, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT07645",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TX",
            "license": "DT07645",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DIETITIAN",
            "identifier": "DT07645",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERD DIETIITIAN",
            "identifier": "895816",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.