Mary E Ortwein, R.D.

Primary specialty

NutritionistTaxonomy code 133N00000X

License

LD000701 Issued in GA

Practice address

603 E Villanow St
La Fayette, GA 30728-2618

Phone

(706) 638-5577

Fax

(706) 638-5543

NPI assigned

Mar 14, 2008

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walker County Board of Health

  • Public Health or Welfare Agency
  • La Fayette, GA
  • NPI 1811908122
  NPD (past)

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1508037854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 E VILLANOW ST",
            "address_2": "PO BOX 609",
            "city": "LA FAYETTE",
            "state": "GA",
            "postal_code": "307282618",
            "telephone_number": "706-638-5577",
            "fax_number": "706-638-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E VILLANOW ST",
            "city": "LA FAYETTE",
            "state": "GA",
            "postal_code": "307282618",
            "telephone_number": "706-638-5577",
            "fax_number": "706-638-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTWEIN",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "GA",
            "license": "LD000701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10072172",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Albert B Nichols
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• Kelly O'Bryant, LMSW
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• Arial Osborn
• Mathew Owens, DMD
• Matthew Parker, DPT
• Kalindi K Patel, PHYSICAL THERAPIST
• Performance Physical Therapy & Sports Medicine Inc

• Nutritionist in La Fayette, GA
• Providers in La Fayette, GA by specialty
• Nutritionist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.