Active NPI
Vanessa O'Toole Supple, R.D.
- Registered Dietitian
- Newton, MA
National Provider Identifier
1023352796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3407
- Practice address
- 2014 Washington St
Nutrition and Food Service Department
Newton, MA 02462-1607 - Phone
- (617) 243-6000
- NPI assigned
- Nov 20, 2012
- 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 | 3407 | MA | Primary |
Addresses
Primary practice location
2014 Washington St
Nutrition and Food Service Department
Newton, MA 02462-1607
Mailing address
2014 Washington St
Nutrition and Food Service Department
Newton, MA 02462-1607
Phone (617) 243-6000
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 |
|---|---|---|---|
| 3407 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1023352796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2014 WASHINGTON ST",
"address_2": "NUTRITION AND FOOD SERVICE DEPARTMENT",
"city": "NEWTON",
"state": "MA",
"postal_code": "024621607",
"telephone_number": "617-243-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2014 WASHINGTON ST",
"address_2": "NUTRITION AND FOOD SERVICE DEPARTMENT",
"city": "NEWTON",
"state": "MA",
"postal_code": "024621607",
"telephone_number": "617-243-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPPLE",
"first_name": "VANESSA",
"middle_name": "O'TOOLE",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-20",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "3407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.