Individual provider Active NPI

Mark Thiesmeyer, RD

  • Registered Dietitian
  • Ann Arbor, MI
National Provider Identifier
1952706574
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
944489 Issued in MI
Practice address
1507 Abbott Ave
Ann Arbor, MI 48103-4103
Phone
(734) 644-5486
NPI assigned
Oct 24, 2014
Last updated
Oct 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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 944489 MI Primary

Addresses

Primary practice location

1507 Abbott Ave
Ann Arbor, MI 48103-4103

Mailing address

1507 Abbott Ave
Ann Arbor, MI 48103-4103
Phone (734) 644-5486

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

LicenseStateTypeSpecialty
944489MIMDRegistered Dietitian

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": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1952706574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 ABBOTT AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034103",
            "telephone_number": "734-644-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 ABBOTT AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034103",
            "telephone_number": "734-644-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESMEYER",
        "first_name": "MARK",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "944489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.