Mary Ann Blakeney, RD

Key facts

NPI

1467562702

Entity type

Individual (NPI type 1)

Primary specialty

Registered Dietitian 133V00000X

License

R403414

Practice address

1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116

Phone

(601) 362-4471

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467562702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 MOSS FOREST CIR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112906",
            "telephone_number": "601-362-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165116",
            "telephone_number": "601-362-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKENEY",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "R403414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

• Linda Carol Blackwell, LPC, LMFT
• Loren Kay Blackwell, CCC-SLP
• Barbara Estelle Blair, MD
• Kendall T Blake, MD
• Kristen Donald Blakeney, FNP-C
• Harold Jason Blalock, M.D.
• Alisha Jean Patricia Bland, MD
• Bridgette Ann Bland, OTR/L
• Paula Leigh Bland, AGNP
• Meghan Blankenship, NP

All providers in Jackson, MS · Registered Dietitian in Mississippi