Active NPI
Mary Kathryn Maxey, R.D.
- Registered Dietitian
- Wauwatosa, WI
National Provider Identifier
1821348335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2699-29
- Practice address
- 1515 Mower Court
Wauwatosa, WI 53213 - Phone
- (414) 704-0063
- NPI assigned
- Sep 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 2699-29 | WI | Primary |
Addresses
Primary practice location
1515 Mower Court
Wauwatosa, WI 53213
Mailing address
1515 Mower Court
Wauwatosa, WI 53213
Phone (414) 704-0063
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 |
|---|---|---|---|
| 2699-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389657600000",
"number": "1821348335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 MOWER COURT",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "53213",
"telephone_number": "414-704-0063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 MOWER COURT",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "53213",
"telephone_number": "414-704-0063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXEY",
"first_name": "MARY",
"middle_name": "KATHRYN",
"name_prefix": "Mrs.",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-12",
"last_updated": "2014-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2699-29",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.