Active NPI
Maurine Thieszen, R.D.
- Registered Dietitian
- Lake City, IA
National Provider Identifier
1588706261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 00509
- Practice address
- 1301 W Main St
Lake City, IA 51449-1585 - Phone
- (712) 464-3171
- Fax
- (712) 464-3269
- NPI assigned
- Feb 12, 2007
- Last updated
- Jan 12, 2012
- 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 | 00509 | IA | Primary |
Addresses
Primary practice location
1301 W Main St
Lake City, IA 51449-1585
Mailing address
1301 W Main St
Lake City, IA 51449-1585
Phone (712) 464-3171
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 |
|---|---|---|---|
| 00509 | IA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326326400000",
"number": "1588706261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 W MAIN ST",
"city": "LAKE CITY",
"state": "IA",
"postal_code": "514491585",
"telephone_number": "712-464-3171",
"fax_number": "712-464-3269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 W MAIN ST",
"city": "LAKE CITY",
"state": "IA",
"postal_code": "514491585",
"telephone_number": "712-464-3171",
"fax_number": "712-464-3269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIESZEN",
"first_name": "MAURINE",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2012-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "00509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, IA
- Stewart Memorial Community Hospital (Stewart Memorial Clinic Lake City)
- Stewart Memorial Community Hospital
- Stewart Memorial Community Hospital
- Stewart Memorial Community Hospital
- Gina Stork, LMHC
- David Joseph Verbik, DDS PHD
- Margaret Mary Vitiritto Khan, DO
- VSL Lake City LLC (Shady Oaks)
- Cassandra M Wetter, R.D.
- Woodlawn Pharmacy
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.