Individual provider Active NPI

Lindsey Rae Mazanec, MS, RD, LD

  • Pediatric Nutrition Registered Dietitian
  • Dallas, TX
National Provider Identifier
1679834394
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
DT82000 Issued in TX
Practice address
1935 Medical District Dr
Clinical Nutrition B3.07
Dallas, TX 75235-7701
Phone
(214) 456-6287
Fax
(214) 456-6287
NPI assigned
May 30, 2012
Last updated
May 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X DT82000 TX Primary

Addresses

Primary practice location

1935 Medical District Dr
Clinical Nutrition B3.07
Dallas, TX 75235-7701

Mailing address

1935 Medical District Dr
Clinical Nutrition B3.07
Dallas, TX 75235-7701

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DT82000TXMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1679834394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "CLINICAL NUTRITION B3.07",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "fax_number": "214-456-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "CLINICAL NUTRITION B3.07",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-6287",
            "fax_number": "214-456-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZANEC",
        "first_name": "LINDSEY",
        "middle_name": "RAE",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TX",
            "license": "DT82000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.