Individual provider Active NPI

Mary Elise Klopfenstein, RD, LD, CDE

  • Registered Dietitian
  • Mount Pleasant, IA
National Provider Identifier
1770714362
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
01731 Issued in IA
Practice address
407 S White St
Mount Pleasant, IA 52641-2263
Phone
(319) 385-6143
Fax
(319) 385-6571
NPI assigned
Jul 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 01731 IA Primary

Addresses

Primary practice location

407 S White St
Mount Pleasant, IA 52641-2263

Mailing address

407 S White St
Mount Pleasant, IA 52641-2263
Phone (319) 385-6143

Other names 1

  • Mary Elise Hazelwood Former name

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
01731IAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1770714362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S WHITE ST",
            "city": "MOUNT PLEASANT",
            "state": "IA",
            "postal_code": "526412263",
            "telephone_number": "319-385-6143",
            "fax_number": "319-385-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S WHITE ST",
            "city": "MOUNT PLEASANT",
            "state": "IA",
            "postal_code": "526412263",
            "telephone_number": "319-385-6143",
            "fax_number": "319-385-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOPFENSTEIN",
        "first_name": "MARY",
        "middle_name": "ELISE",
        "credential": "RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "01731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HAZELWOOD",
            "middle_name": "ELISE",
            "credential": "RD, LD, CDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Pleasant, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.