Marie G Smith, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2305-029 Issued in WI

Practice address

575 4TH St
Kewaunee, WI 54216

Phone

(920) 388-4640

Fax

(920) 388-0479

NPI assigned

Jul 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

94.81 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1447773783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 4TH ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "54216",
            "telephone_number": "920-388-4640",
            "fax_number": "920-388-0479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1715 Dousman St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543033211",
            "country_code": "US",
            "telephone_number": "920-272-1010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "307 Manor Dr",
            "address_purpose": "LOCATION",
            "city": "Suring",
            "state": "WI",
            "postal_code": "541749182",
            "country_code": "US",
            "telephone_number": "920-842-2144",
            "fax_number": "920-842-4111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-433-3500",
            "fax_number": "920-445-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARIE",
        "middle_name": "G",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "2305-029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "PENDING",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Kewaunee, WI
• Providers in Kewaunee, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.