Marisa R Benavides, MS, RD, LD

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

DT05576 Issued in TX

Practice address

6801 McPherson Rd
Suite #226
Laredo, TX 78041-6402

Phone

(956) 717-0113

Fax

(956) 717-2070

NPI assigned

Oct 31, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Gateway Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Laredo, TX
  • NPI 1720192792
  NPD

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1568748846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 MCPHERSON RD",
            "address_2": "SUITE #226",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416402",
            "telephone_number": "956-717-0113",
            "fax_number": "956-717-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 MCPHERSON RD",
            "address_2": "SUITE #226",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416402",
            "telephone_number": "956-717-0113",
            "fax_number": "956-717-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDES",
        "first_name": "MARISA",
        "middle_name": "R",
        "credential": "MS, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "TX",
            "license": "DT05576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Rene Benavides, MD
• Enrique F Benavides Jr., MD
• Enrique F Benavides III, MD
• Luis Benavides
• Luis M Benavides, MD
• Oscar Benavides, MD
• Mara-Alyzza Benavidez
• Bendiciones Home Health Care, Inc
• Charisse Benitez, APRN, FNP-C
• Margarito Benitez, FNP

• Renal Nutrition Registered Dietitian in Laredo, TX
• Providers in Laredo, TX by specialty
• Renal Nutrition Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.