NPIMap

Individual provider Active NPI

Mary Insalaco, LICENSE DIETITIAN

  • Registered Dietitian
  • Saint Louis, MO
National Provider Identifier
1780917237
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2009014930 Issued in MO
Practice address
3115 Wynfield Terrace CT
Saint Louis, MO 63129-3971
Phone
(314) 695-0797
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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 2009014930 MO Primary

Addresses

Primary practice location

3115 Wynfield Terrace CT
Saint Louis, MO 63129-3971

Mailing address

2220 Lemp Ave
Saint Louis, MO 63104-2700
Phone (314) 814-8615

Other names 1

  • Mary Lucca 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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Grace Hill Neighborhood Health Center Inc, Nutritionist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1780917237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 LEMP AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042700",
            "telephone_number": "314-814-8615",
            "fax_number": "314-814-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 WYNFIELD TERRACE CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631293971",
            "telephone_number": "314-695-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INSALACO",
        "first_name": "MARY",
        "credential": "LICENSE DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2009014930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LUCCA",
            "credential": "LICENSE DIETITIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.