Individual provider Active NPI

Marissa Hewitt, RDN

  • Registered Dietitian
  • Clarksville, TN
National Provider Identifier
1871481564
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1197 Belvoir LN
Clarksville, TN 37040-1443
Phone
(734) 546-6622
NPI assigned
Jun 24, 2025
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 Primary

Addresses

Primary practice location

1197 Belvoir LN
Clarksville, TN 37040-1443

Mailing address

1197 Belvoir LN
Clarksville, TN 37040-1443
Phone (734) 546-6622

Other names 1

  • Marissa Fall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250813002619 TN Practitioner - Registered Dietitian Or Nutrition Professional 5294233797 Reassigns benefits to 1 organization
I20250909003731 KY Practitioner - Registered Dietitian Or Nutrition Professional 5294233797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MNT, Inc.Group PAC ID 8820132145, 4 clinicians

Practice addresses (Care Compare)

207 Traditions Blvd
Bowling Green, KY 42103-7957
Phone (270) 901-3412

892 Windsor Green Blvd
Goodlettsville, TN 37072-2136
Phone (270) 901-3412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5254TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MNT, Inc. Dietitian, Registered CurrentSince Jun 26, 2025 Accepting new patients

Locations

1994 Gallatin Pike N
Ste 30
Madison, TN 37115

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1871481564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1197 BELVOIR LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370401443",
            "telephone_number": "734-546-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1197 BELVOIR LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370401443",
            "telephone_number": "734-546-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEWITT",
        "first_name": "MARISSA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "FALL",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.