Individual provider Active NPI

Rosemary Anne Squires, MA, RD

  • Registered Dietitian
  • Central Square, NY
National Provider Identifier
1023676780
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86095899 Issued in NY
Practice address
661 S Main St
Central Square, NY 13036-9111
Phone
(315) 935-5321
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86095899 NY Primary

Addresses

Primary practice location

661 S Main St
Central Square, NY 13036-9111

Mailing address

661 S Main St
Central Square, NY 13036-9111
Phone (315) 935-5321

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
86095899NYMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1023676780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 S MAIN ST",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130369111",
            "telephone_number": "315-935-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 S MAIN ST",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130369111",
            "telephone_number": "315-935-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "ROSEMARY",
        "middle_name": "ANNE",
        "credential": "MA, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86095899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Square, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.