Active NPI
Mary J Bailey, RD, LMNT
- Registered Dietitian
- Grand Island, NE
National Provider Identifier
1780761874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 415
- Practice address
- 2620 W Faidley Ave
Grand Island, NE 68803-4205 - Phone
- (308) 398-5315
- Fax
- (308) 398-6565
- NPI assigned
- Nov 1, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 415 | NE | Primary |
Addresses
Primary practice location
2620 W Faidley Ave
Grand Island, NE 68803-4205
Mailing address
2620 W Faidley Ave
P O Box 9804
Grand Island, NE 68803-4205
Phone (308) 398-5315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 415 | Other | NE | LMNT |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1780761874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2620 W FAIDLEY AVE",
"address_2": "P O BOX 9804",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688034205",
"telephone_number": "308-398-5315",
"fax_number": "308-398-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 W FAIDLEY AVE",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688034205",
"telephone_number": "308-398-5315",
"fax_number": "308-398-6565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "MARY",
"middle_name": "J",
"credential": "RD, LMNT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NE",
"license": "415",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMNT",
"identifier": "415",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.