Individual provider Active NPI

Mary Shannon Feeney, R.D., LDN

  • Registered Dietitian
  • Scranton, PA
National Provider Identifier
1437475571
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN004339 Issued in PA
Practice address
640 Madison Ave
Scranton, PA 18510-1631
Phone
(570) 340-2378
Fax
(570) 207-4123
NPI assigned
Apr 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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 DN004339 PA Primary

Addresses

Primary practice location

640 Madison Ave
Scranton, PA 18510-1631

Mailing address

640 Madison Ave
Scranton, PA 18510-1631
Phone (570) 340-2378

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

LicenseStateTypeSpecialty
DN004339PAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1437475571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101631",
            "telephone_number": "570-340-2378",
            "fax_number": "570-207-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101631",
            "telephone_number": "570-340-2378",
            "fax_number": "570-207-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEENEY",
        "first_name": "MARY",
        "middle_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "R.D., LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.