Marissa Karen Spickerman, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86119368 Issued in MI

Practice address

1750 E Bellows St
Mt Pleasant, MI 48858-3872

Phone

(989) 953-5804

NPI assigned

Jun 30, 2021

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1699345777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 PLEASANT ST APT 6",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583489",
            "telephone_number": "231-245-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E BELLOWS ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583872",
            "telephone_number": "989-953-5804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sheridan",
            "state": "MI",
            "postal_code": "488849235",
            "country_code": "US",
            "telephone_number": "989-291-3261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPICKERMAN",
        "first_name": "MARISSA",
        "middle_name": "KAREN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "86119368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mkspickerman@pacecmi.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1750 E Bellows St",
            "city": "MT Pleasant",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488583872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mspickerman@sheridanhospital.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 N Main St",
            "city": "Sheridan",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488849235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Mt Pleasant, MI
• Registered Dietitian in Michigan

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

Verify at the official NPI Registry.