Individual provider Active NPI

Marjorie Conrad Rich, MS, RD, LD, CDE

  • Metabolic Nutrition Registered Dietitian
  • Boise, ID
National Provider Identifier
1558664755
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
D-038 Issued in ID
Practice address
707 N Armstrong PL
Boise, ID 83704-0825
Phone
(208) 861-1777
NPI assigned
Dec 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X D-038 ID Primary

Addresses

Primary practice location

707 N Armstrong PL
Boise, ID 83704-0825

Mailing address

2519 N Esquire Dr
Boise, ID 83704-6210
Phone (208) 377-5881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130117000335 ID Practitioner - Registered Dietitian Or Nutrition Professional 1557514833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 12TH Ave Rd
Suite 200
Nampa, ID 83686-6008
Phone (208) 302-6899

1512 12TH Ave Rd
Suite 100
Nampa, ID 83686-6008
Phone (208) 467-1171

3025 W Cherry LN
Meridian, ID 83642-8531

901 N Curtis Rd
Boise, ID 83706-1343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D-038IDMDMetabolic Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Dec 1, 2012 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Dec 1, 2012 Accepting new patients

Locations

901 N Curtis Rd
Ste 501
Boise, ID 83706
Phone (208) 302-3900

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Organizations & group practices 2

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": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1558664755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 N ESQUIRE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837046210",
            "telephone_number": "208-377-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N ARMSTRONG PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837040825",
            "telephone_number": "208-861-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "MARJORIE",
        "middle_name": "CONRAD",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "ID",
            "license": "D-038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.