Active NPI
Marissa Fleming, MS, RDN, LDN
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1649946393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.007951
- Practice address
- 2003 W Fulton St
Chicago, IL 60612-2345 - Phone
- (312) 850-3438
- NPI assigned
- Aug 20, 2021
- 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 | 164.007951 | IL | Primary |
Addresses
Primary practice location
2003 W Fulton St
Chicago, IL 60612-2345
Mailing address
332 N Salem Ave Apt 2G
Arlington Heights, IL 60005-1331
Phone (773) 699-9127
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.007951 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1649946393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 N SALEM AVE APT 2G",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600051331",
"telephone_number": "773-699-9127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2003 W FULTON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606122345",
"telephone_number": "312-850-3438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLEMING",
"first_name": "MARISSA",
"credential": "MS, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-20",
"last_updated": "2021-08-20",
"certification_date": "2021-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.007951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.