Mary Jo Ambroz, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1536 Issued in MN

Practice address

523 N 3Rd St
Brainerd, MN 56401-3054

Phone

(218) 828-7378

Fax

(218) 828-7686

NPI assigned

Dec 12, 2006

Last updated

Sep 18, 2007By the provider in NPPES

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

Practice roles

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.

• St. Joseph's Medical Center

  dba Essentia Health St. Joseph's-Pillager Clinic

  • Primary Care Clinic/Center
  • Pillager, MN
  • NPI 1891740957
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1649330176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-828-7378",
            "fax_number": "218-828-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-828-7378",
            "fax_number": "218-828-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROZ",
        "first_name": "MARY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "1536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Catherine Addison, RN
• Adventures Within LLC
• Advocates for Reproductive Education
• Linda Marie Ahern, RPH
• Amy Aho
• Laura Amundson, OTR/L
• Steven Lynn Andersen, MD
• Corey Robert Anderson, MD
• Harvey E Anderson, M.D.
• Janis D. Anderson, MA

• Registered Dietitian in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.