Marissa L Engelhardt, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86098171 Issued in MI

Practice address

555 Linn St
Allegan, MI 49010-1524

Phone

(269) 686-4251

NPI assigned

Nov 24, 2020

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1578167235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 LINN ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101524",
            "telephone_number": "989-450-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 LINN ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101524",
            "telephone_number": "269-686-4251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hemlock St",
            "address_purpose": "LOCATION",
            "city": "Tawas City",
            "state": "MI",
            "postal_code": "487639237",
            "country_code": "US",
            "telephone_number": "989-362-9460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENGELHARDT",
        "first_name": "MARISSA",
        "middle_name": "L",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "86098171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan E Doyle, MSW
• Dr. Luciano Giovannucci P.C. (Riverfront Chiropractic)
• Mirna Dusek
• John Eagle Jr., LMSW
• Bradley Michael Eddy
• Eric Richard Erickson, DDS
• Brandy Lynn Erlandson, BS, QMHP
• Evan a. Be, D.D.S., P.L.C.
• Elizabeth A Evans, LLMSW
• Cristina Evette Eversole, OTD, OTR/L

• Registered Dietitian in Allegan, MI
• Providers in Allegan, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.