Active NPI
Mary Sue Klinger, RD LD CDE
- Registered Dietitian
- Stillwater, OK
National Provider Identifier
1528167418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 845
- Practice address
- 1323 W 6TH Ave
Stillwater, OK 74074-4306 - Phone
- (405) 742-5676
- Fax
- (405) 742-5610
- NPI assigned
- Sep 21, 2006
- Last updated
- May 2, 2013
- 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 | 845 | OK | Primary |
Addresses
Primary practice location
1323 W 6TH Ave
Stillwater, OK 74074-4306
Mailing address
PO Box 414
Perry, OK 73077-0414
Phone (580) 336-4157
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 845 | Other | OK | DIETICIAN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 845 | OK | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367452800000",
"number": "1528167418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 414",
"city": "PERRY",
"state": "OK",
"postal_code": "730770414",
"telephone_number": "580-336-4157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1323 W 6TH AVE",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740744306",
"telephone_number": "405-742-5676",
"fax_number": "405-742-5610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINGER",
"first_name": "MARY",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "RD LD CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2013-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "845",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIETICIAN",
"identifier": "845",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.