Active NPI
Christopher Martin Liddy, R.D.
- Registered Dietitian
- Holly Springs, MS
National Provider Identifier
1598164147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D0318
- Practice address
- 575 Craft St
Holly Springs, MS 38635-3249 - Phone
- (662) 252-2285
- Fax
- (662) 252-2394
- NPI assigned
- Aug 20, 2014
- Last updated
- Aug 20, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | D0318 | MS | Primary |
Addresses
Primary practice location
575 Craft St
Holly Springs, MS 38635-3249
Mailing address
PO Box 308
Holly Springs, MS 38635-0308
Phone (662) 252-2285
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0318 | MS | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Mississippi CVS Pharmacy LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408492800000",
"number": "1598164147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 308",
"city": "HOLLY SPRINGS",
"state": "MS",
"postal_code": "386350308",
"telephone_number": "662-252-2285",
"fax_number": "662-252-2394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 CRAFT ST",
"city": "HOLLY SPRINGS",
"state": "MS",
"postal_code": "386353249",
"telephone_number": "662-252-2285",
"fax_number": "662-252-2394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIDDY",
"first_name": "CHRISTOPHER",
"middle_name": "MARTIN",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-20",
"last_updated": "2014-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MS",
"license": "D0318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.