Active NPI
Brianna Mahoney
- Registered Dietitian
- Clearwater, FL
National Provider Identifier
1982322400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 11453
- Practice address
- 7204 Amhurst Way
Clearwater, FL 33764-7001 - Phone
- (352) 584-6394
- NPI assigned
- Aug 19, 2022
- 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 | 11453 | FL | Primary |
Addresses
Primary practice location
7204 Amhurst Way
Clearwater, FL 33764-7001
Mailing address
7204 Amhurst Way
Clearwater, FL 33764-7001
Phone (352) 584-6394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2010
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7204 Amhurst Way
Clearwater, FL 33764-7001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11453 | FL | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Balanced Living Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Registered Dietitian
- Clearwater, FL
- NPI 1629948567
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660867200000",
"number": "1982322400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7204 AMHURST WAY",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337647001",
"telephone_number": "352-584-6394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7204 AMHURST WAY",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337647001",
"telephone_number": "352-584-6394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "BRIANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-19",
"last_updated": "2022-08-19",
"certification_date": "2022-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "11453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.