Mary Kathleen Mandry, RD, LD/N

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND2333 Issued in FL

Practice address

1510 Citrus Medical CT
Ocoee, FL 34761-4547

Phone

(407) 480-4830

Fax

(407) 480-4834

NPI assigned

Nov 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Mary Kathleen Campbell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73554

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• West Orange Endocrinology, PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Ocoee, FL
  • NPI 1225688237
  NPD

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689188385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 CITRUS MEDICAL CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614547",
            "telephone_number": "407-480-4830",
            "fax_number": "407-480-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 CITRUS MEDICAL CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614547",
            "telephone_number": "407-480-4830",
            "fax_number": "407-480-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDRY",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "RD, LD/N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND2333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CAMPBELL",
            "middle_name": "KATHLEEN",
            "prefix": "MRS.",
            "credential": "RD LD/N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nick Ashok Mahavir, DPM
• Abdul Salam Majid, MD
• Paul Maluso, MD
• Bryan Manarte
• Jose M Mandry, M.D.
• Parimal Bhupendra Maniar, M.D.
• Mark T Machuga P a
• Lanna Marseille
• Scott David Marsel, MD
• Javier Ernesto Martinez, DDS, MS, PA

• Registered Dietitian in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Registered Dietitian in Florida

• 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.

Verify at the official NPI Registry.