Active NPI
Marykay Grossman, RD
- Registered Dietitian
- Spokane, WA
National Provider Identifier
1942526264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI00000773
- Practice address
- 322 W North River Dr
Spokane, WA 99201-3208 - Phone
- (509) 324-6464
- Fax
- (509) 241-2056
- NPI assigned
- Apr 12, 2010
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DI00000773 | WA | Primary |
Addresses
Primary practice location
322 W North River Dr
Spokane, WA 99201-3208
Mailing address
322 W North River Dr
Spokane, WA 99201-3208
Phone (509) 324-6464
Other names 1
- Mary Kathryn Davis
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI00000773 | WA | MD | Registered Dietitian |
Interoperability endpoints
- mgrossman207871@ghc.direct-ci.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1942526264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 W NORTH RIVER DR",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992013208",
"telephone_number": "509-324-6464",
"fax_number": "509-241-2056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 W NORTH RIVER DR",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992013208",
"telephone_number": "509-324-6464",
"fax_number": "509-241-2056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "MARYKAY",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-12",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI00000773",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "322 W North River Dr",
"city": "Spokane",
"state": "WA",
"country_code": "US",
"postal_code": "992013208",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARY",
"last_name": "DAVIS",
"middle_name": "KATHRYN",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.