Active NPI
Marsha M Fendley, RD, LD, CDE
- Registered Dietitian
- Monroeville, AL
National Provider Identifier
1508069501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 130
- Practice address
- 2016 S Alabama Ave
Monroeville, AL 36460-3044 - Phone
- (251) 575-3111
- Fax
- (251) 743-7493
- NPI assigned
- Jun 7, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 130 | AL | |
| Registered Dietitian | 133V00000X | 130 | AL | Primary |
Addresses
Primary practice location
2016 S Alabama Ave
Monroeville, AL 36460-3044
Mailing address
PO Box 886
Monroeville, AL 36461-0886
Phone (251) 575-3111
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0972-0106 | Other | AL | DIABETES EDUCATION CERTIF |
| 467211 | Other | NATIONAL REGISTRATION NO. | |
| 130 | Other | AL | DIETITIAN LICENSE |
Other names 1
- Marsha Faye McIntyre
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": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403136000000",
"number": "1508069501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 886",
"city": "MONROEVILLE",
"state": "AL",
"postal_code": "364610886",
"telephone_number": "251-575-3111",
"fax_number": "251-743-7493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2016 S ALABAMA AVE",
"city": "MONROEVILLE",
"state": "AL",
"postal_code": "364603044",
"telephone_number": "251-575-3111",
"fax_number": "251-743-7493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENDLEY",
"first_name": "MARSHA",
"middle_name": "M",
"credential": "RD, LD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-07",
"last_updated": "2014-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "AL",
"license": "130",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AL",
"license": "130",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIABETES EDUCATION CERTIF",
"identifier": "0972-0106",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL REGISTRATION NO.",
"identifier": "467211",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIETITIAN LICENSE",
"identifier": "130",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARSHA",
"last_name": "MCINTYRE",
"middle_name": "FAYE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Monroeville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.