Individual provider Active NPI

Mallory Ann Ziegler

  • Gerontological Nutrition Registered Dietitian
  • Elizabethtown, PA
National Provider Identifier
1659989291
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontological Nutrition Registered DietitianTaxonomy code 133VN1101X
License
DN006937 Issued in PA
Practice address
642 Aberdeen Rd
Elizabethtown, PA 17022-9451
Phone
(717) 808-1656
NPI assigned
Jul 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontological Nutrition Registered Dietitian 133VN1101X DN006937 PA Primary

Addresses

Primary practice location

642 Aberdeen Rd
Elizabethtown, PA 17022-9451

Mailing address

642 Aberdeen Rd
Elizabethtown, PA 17022-9451
Phone (717) 808-1656

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
DN006937PAMDGerontological Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1659989291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 ABERDEEN RD",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170229451",
            "telephone_number": "717-808-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 ABERDEEN RD",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170229451",
            "telephone_number": "717-808-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEGLER",
        "first_name": "MALLORY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1101X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Gerontological",
            "state": "PA",
            "license": "DN006937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.