Active NPI
Marie Ange Etienne, RD,LD
- Registered Dietitian
- Riviera Beach, FL
National Provider Identifier
1649362898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND3972
- Practice address
- 7305 N Military TRL
Riviera Beach, FL 33410-7417 - Phone
- (561) 422-6267
- Fax
- (561) 422-5766
- NPI assigned
- Sep 28, 2006
- Last updated
- Jul 21, 2022
- Sex
- Female
- 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 | ND3972 | FL | Primary |
Addresses
Primary practice location
7305 N Military TRL
Riviera Beach, FL 33410-7417
Mailing address
5412 Eastbay Dr
Greenacres, FL 33463-5960
Phone (561) 963-8746
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 |
|---|---|---|---|
| ND3972 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
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": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1649362898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5412 EASTBAY DR",
"city": "GREENACRES",
"state": "FL",
"postal_code": "334635960",
"telephone_number": "561-963-8746",
"fax_number": "561-963-8746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7305 N MILITARY TRL",
"city": "RIVIERA BEACH",
"state": "FL",
"postal_code": "334107417",
"telephone_number": "561-422-6267",
"fax_number": "561-422-5766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE",
"first_name": "MARIE",
"middle_name": "ANGE",
"name_prefix": "Mrs.",
"credential": "RD,LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND3972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riviera Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.