Active NPI
Mary Margaret McCreery, R.D.
- Registered Dietitian
- Neosho, MO
National Provider Identifier
1487967071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2002008087
- Practice address
- 113 W Hickory St
Neosho, MO 64850-1705 - Phone
- (417) 347-4309
- Fax
- (417) 347-9268
- NPI assigned
- Jul 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2002008087 | MO | Primary |
Addresses
Primary practice location
113 W Hickory St
Neosho, MO 64850-1705
Mailing address
12713 Highway M
Stark City, MO 64866-8053
Phone (417) 850-2013
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 916277 | Other | MO | REGISTAR DIETITAN LICENSE |
| 2041-0267 | Other | CERTIFIED DIABETES EDUCATOR | |
| 20020080887 | Other | MO | STATE COMMITTE OF DIETITIAN LICENSED |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282608000000",
"number": "1487967071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12713 HIGHWAY M",
"city": "STARK CITY",
"state": "MO",
"postal_code": "648668053",
"telephone_number": "417-850-2013",
"fax_number": "417-347-9268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 W HICKORY ST",
"city": "NEOSHO",
"state": "MO",
"postal_code": "648501705",
"telephone_number": "417-347-4309",
"fax_number": "417-347-9268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCREERY",
"first_name": "MARY",
"middle_name": "MARGARET",
"name_prefix": "Mrs.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-23",
"last_updated": "2010-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2002008087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTAR DIETITAN LICENSE",
"identifier": "916277",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED DIABETES EDUCATOR",
"identifier": "2041-0267",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE COMMITTE OF DIETITIAN LICENSED",
"identifier": "20020080887",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Neosho, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.