Individual provider Active NPI

Latisha Shamecca Marks, R.D., L.D.

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Mansfield, TX
National Provider Identifier
1649618869
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
Practice address
1301 E Debbie LN
Mansfield, TX 76063-3305
Phone
(945) 225-3504
NPI assigned
Jun 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 007709 NY
Registered Dietitian 133V00000X DT88322 TX
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X Primary

Addresses

Primary practice location

1301 E Debbie LN
Mansfield, TX 76063-3305

Mailing address

1301 East Debbie Lane
Ste 102 PMB# 184
Mansfield, TX 76063-3376
Phone (945) 225-3504

Other practice location 1

1900 E Main St
Nutrition and Food Services (120)
Danville, IL 61832-5100
Phone (217) 554-5807

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

LicenseStateTypeSpecialty
007709NYMDRegistered Dietitian
DT88322TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1649618869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 EAST DEBBIE LANE",
            "address_2": "STE 102 PMB# 184",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633376",
            "telephone_number": "945-225-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E DEBBIE LN",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633305",
            "telephone_number": "945-225-3504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 E Main St",
            "address_2": "Nutrition and Food Services (120)",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "IL",
            "postal_code": "618325100",
            "country_code": "US",
            "telephone_number": "217-554-5807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "LATISHA",
        "middle_name": "SHAMECCA",
        "name_prefix": "Ms.",
        "credential": "R.D., L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2025-04-01",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "007709",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT88322",
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.