Individual provider Active NPI

Mary Lou Barrette, RD

  • Registered Dietitian
  • Auburn, NY
National Provider Identifier
1487717476
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
002272-1 Issued in NY
Practice address
6072 Oakridge Road
Auburn, NY 13021-9645
Phone
(315) 252-0434
Fax
(315) 252-0434
NPI assigned
Dec 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 002272-1 NY Primary

Addresses

Primary practice location

6072 Oakridge Road
Auburn, NY 13021-9645

Mailing address

6072 Oakridge Rd
Auburn, NY 13021-9645
Phone (315) 252-0434

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

State licenses

LicenseStateTypeSpecialty
002272-1NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487717476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6072 OAKRIDGE RD",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130219645",
            "telephone_number": "315-252-0434",
            "fax_number": "315-252-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6072 OAKRIDGE ROAD",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130219645",
            "telephone_number": "315-252-0434",
            "fax_number": "315-252-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETTE",
        "first_name": "MARY LOU",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "002272-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.