Mary Wilson, RD
NPI 1366115461 · Registered Dietitian · Southlake, TX
Enrolled with Medicare as Practitioner - Registered Dietitian Or Nutrition Professional · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mary Wilson, RD is a Registered Dietitian provider in Southlake, TX (NPI 1366115461).
Provider details
- NPI number
- 1366115461
- Entity type
- Individual
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- License
- 86151599 (TX)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 505 S Nolen DrSouthlake, TX 76092-9167Phone: (214) 623-6270
Registry dates
- Enumerated
- 2021-07-26
- Last updated
- 2021-07-26
- Certified
- 2021-07-23
Frequently asked questions
- What is Mary Wilson's NPI number?
- Mary Wilson's National Provider Identifier (NPI) is 1366115461, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mary Wilson's specialty?
- Mary Wilson is listed in the NPPES registry with a primary specialty of Registered Dietitian (Dietary & Nutritional Service Providers).
- Where is Mary Wilson located?
- Mary Wilson's practice location on file with NPPES is 620 E Southlake Blvd, Southlake, TX 76092-6236.
- What is Mary Wilson's phone number?
- The practice phone number listed in the NPPES registry for Mary Wilson is (214) 623-6270.
- Does Mary Wilson accept Medicare?
- Mary Wilson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mary Wilson's NPI active?
- Yes — Mary Wilson's NPI (1366115461) is active in the NPPES registry as of the last update on 2021-07-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.