Active NPI
Jane E Lively, RD
- Registered Dietitian
- Bedford, MA
National Provider Identifier
1013942960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1000
- Practice address
- 200 Springs Rd
Enrm VA Hospital
Bedford, MA 01730-1198 - Phone
- (781) 687-2570
- NPI assigned
- Jul 11, 2006
- Last updated
- Jul 8, 2007
- 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 | 1000 | MA | Primary |
Addresses
Primary practice location
200 Springs Rd
Enrm VA Hospital
Bedford, MA 01730-1198
Mailing address
71 Pompositticutt St
Stow, MA 01775-1136
Phone (978) 897-9462
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 |
|---|---|---|---|
| 1000 | MA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013942960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 POMPOSITTICUTT ST",
"city": "STOW",
"state": "MA",
"postal_code": "017751136",
"telephone_number": "978-897-9462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SPRINGS RD",
"address_2": "ENRM VA HOSPITAL",
"city": "BEDFORD",
"state": "MA",
"postal_code": "017301198",
"telephone_number": "781-687-2570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIVELY",
"first_name": "JANE",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "1000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.