Active NPI
Sophie Martin, LD, RD
- Registered Dietitian
- Bronx, NY
National Provider Identifier
1003455130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86153022
- Practice address
- 1802 Crotona Ave
Bronx, NY 10457-6621 - Phone
- (917) 607-3312
- NPI assigned
- Jan 6, 2020
- 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 | 86153022 | TX | Primary |
Addresses
Primary practice location
1802 Crotona Ave
Bronx, NY 10457-6621
Mailing address
1802 Crotona Ave
Bronx, NY 10457-6621
Phone (917) 607-3312
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86153022 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1003455130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 CROTONA AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104576621",
"telephone_number": "917-607-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 CROTONA AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104576621",
"telephone_number": "917-607-3312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SOPHIE",
"credential": "LD, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-06",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "86153022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.