Individual provider Active NPI

Mary Elizabeth Hunt, RD, CSP

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1881050003
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1031634 Issued in AZ
Practice address
635 E Baseline Rd
Phoenix, AZ 85042-6551
Phone
(602) 243-7277
NPI assigned
Jan 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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 1031634 AZ Primary

Addresses

Primary practice location

635 E Baseline Rd
Phoenix, AZ 85042-6551

Mailing address

3003 N Central Ave Ste 1600
Phoenix, AZ 85012-2908
Phone (602) 323-3492

Other identifiers 1

IdentifierTypeStateIssuer
097858MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160115000712 AZ Practitioner - Registered Dietitian Or Nutrition Professional 8325341803 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1031634AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center CurrentSince Jan 19, 2016 Accepting new patients
Mountain Park Health Center CurrentSince Jan 19, 2016 Accepting new patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center Past Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients

Locations

635 E Baseline Rd
Phoenix, AZ 85042

6601 W Thomas Rd
Phoenix, AZ 85033

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

Organizations & group practices 5

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": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1881050003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122908",
            "telephone_number": "602-323-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426551",
            "telephone_number": "602-243-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNT",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "RD, CSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "1031634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097858",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.