Individual provider Active NPI

Marsha Jehung Ungchusri, RD, LD

  • Pediatric Nutrition Registered Dietitian
  • Dallas, TX
National Provider Identifier
1811392012
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
#DT83498 Issued in TX
Practice address
1935 Medical District Dr
Clinical Nutrition D2.03
Dallas, TX 75235-7701
Phone
(214) 456-0314
Fax
(214) 456-6287
NPI assigned
Oct 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X #DT83498 TX Primary

Addresses

Primary practice location

1935 Medical District Dr
Clinical Nutrition D2.03
Dallas, TX 75235-7701

Mailing address

1935 Medical District Dr
Clinical Nutrition D2.03
Dallas, TX 75235-7701
Phone (214) 456-0314

Other identifiers 2

IdentifierTypeStateIssuer
#DT83498OtherTXLICENSED DIETITIAN
86014194OtherTXREGISTERED DIETITIAN

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
#DT83498TXMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1811392012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "CLINICAL NUTRITION D2.03",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-0314",
            "fax_number": "214-456-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "address_2": "CLINICAL NUTRITION D2.03",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-0314",
            "fax_number": "214-456-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGCHUSRI",
        "first_name": "MARSHA",
        "middle_name": "JEHUNG",
        "name_prefix": "Ms.",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TX",
            "license": "#DT83498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DIETITIAN",
            "identifier": "#DT83498",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETITIAN",
            "identifier": "86014194",
            "state": "TX"
        }
    ],
    "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 Oct 30, 2014; 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.