Individual provider Active NPI

Noelle Mennen

  • Registered Dietitian
  • Liberty, MO
National Provider Identifier
1508692872
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2023045194 Issued in MO
Practice address
109 N Blue Jay Dr
Liberty, MO 64068-1906
Phone
(816) 792-3210
NPI assigned
Sep 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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 2023045194 MO Primary

Addresses

Primary practice location

109 N Blue Jay Dr
Liberty, MO 64068-1906

Mailing address

109 N Blue Jay Dr
Liberty, MO 64068-1906

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hy-Vee Health PC CurrentSince Jul 20, 2024 Accepting new patients
Hy-Vee Health PC Dietitian, Registered CurrentSince Jul 20, 2024 Accepting new patients
Hy-Vee Health PC Past Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

5820 Westown Pkwy
West Des Moines, IA 50266
Phone (515) 453-2784

301 NE Rice Rd
Lees Summit, MO 64086
Phone (816) 251-5760

109 N Blue Jay Dr
Liberty, MO 64068
Phone (816) 691-1424

1720 W Battlefield St
Springfield, MO 65807
Phone (417) 881-1217

2150 E Sunshine St
Springfield, MO 65804
Phone (417) 444-6861

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1508692872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N BLUE JAY DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N BLUE JAY DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681906",
            "telephone_number": "816-792-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENNEN",
        "first_name": "NOELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2023045194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.