Active NPI
Marie Antoinette Patti, RD
- Nutritionist
- Dallas, TX
National Provider Identifier
1811108772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 000556
- Practice address
- 1100 Commerce Street
Usda, Southwest Regional Office
Dallas, TX 75242-0000 - Phone
- (214) 290-9889
- Fax
- (214) 767-5522
- NPI assigned
- May 24, 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 000556 | CT | Primary |
Addresses
Primary practice location
1100 Commerce Street
Usda, Southwest Regional Office
Dallas, TX 75242-0000
Mailing address
1222 Commerce St
Apt 701
Dallas, TX 75202-4302
Phone (860) 884-5184
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000556 | Other | CT | STATE NUTRITIONIST LICENS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000556 | CT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811108772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1222 COMMERCE ST",
"address_2": "APT 701",
"city": "DALLAS",
"state": "TX",
"postal_code": "752024302",
"telephone_number": "860-884-5184",
"fax_number": "214-767-5522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 COMMERCE STREET",
"address_2": "USDA, SOUTHWEST REGIONAL OFFICE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752420000",
"telephone_number": "214-290-9889",
"fax_number": "214-767-5522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTI",
"first_name": "MARIE",
"middle_name": "ANTOINETTE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "CT",
"license": "000556",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE NUTRITIONIST LICENS",
"identifier": "000556",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.