Active NPI
Roselynne Angelina Mackay, MS, CNS, LDN
- Nutritionist
- Clarksville, MD
National Provider Identifier
1497537476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 18410
- Practice address
- 6030 Daybreak Cir # A150-185
Clarksville, MD 21029-1642 - Phone
- (844) 856-9355
- NPI assigned
- Oct 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DX6002 | MD | |
| Nutritionist | 133N00000X | 18410 | Primary |
Addresses
Primary practice location
6030 Daybreak Cir # A150-185
Clarksville, MD 21029-1642
Mailing address
5825 Gateway Blvd
Stone Mountain, GA 30087-6053
Phone (301) 806-0614
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
- Credentials
- Certified Nurse Specialist, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DX6002 | MD | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697414400000",
"number": "1497537476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5825 GATEWAY BLVD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300876053",
"telephone_number": "301-806-0614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6030 DAYBREAK CIR # A150-185",
"city": "CLARKSVILLE",
"state": "MD",
"postal_code": "210291642",
"telephone_number": "844-856-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKAY",
"first_name": "ROSELYNNE",
"middle_name": "ANGELINA",
"credential": "MS, CNS, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-16",
"last_updated": "2023-10-16",
"certification_date": "2023-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX6002",
"primary": false
},
{
"code": "133N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nutritionist",
"state": null,
"license": "18410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.