Active NPI
Jennifer Heinen, RD
- Registered Dietitian
- Cambridge, MA
National Provider Identifier
1033547039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 2557 Massachusetts Ave
Cambridge, MA 02140-1020 - Phone
- (617) 744-9233
- Fax
- (617) 300-8910
- NPI assigned
- Oct 29, 2013
- Last updated
- Jul 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | NU | Primary |
Addresses
Primary practice location
2557 Massachusetts Ave
Cambridge, MA 02140-1020
Mailing address
41 Harrington St
Watertown, MA 02472-1015
Phone (917) 692-8270
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1085992 RD# | Other | MA | RD |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish for Life | Dietitian, Registered | Current | Accepting new patients |
Locations
2557 Massachusetts Ave
Cambridge, MA 02140
Phone (617) 492-3185
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658448000000",
"number": "1033547039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 HARRINGTON ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024721015",
"telephone_number": "917-692-8270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2557 MASSACHUSETTS AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021401020",
"telephone_number": "617-744-9233",
"fax_number": "617-300-8910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINEN",
"first_name": "JENNIFER",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-29",
"last_updated": "2022-07-22",
"certification_date": "2022-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RD",
"identifier": "1085992 RD#",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.