Active NPI
Kathleen Marie Hickey, RDN LDN
- Registered Dietitian
- Melrose, MA
National Provider Identifier
1043031339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN7654
- Practice address
- 168 Woodcrest Dr
Melrose, MA 02176-3418 - Phone
- (781) 307-0046
- NPI assigned
- Oct 21, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L008181 | NC | |
| Registered Dietitian | 133V00000X | LDN7654 | MA | Primary |
Addresses
Primary practice location
168 Woodcrest Dr
Melrose, MA 02176-3418
Mailing address
168 Woodcrest Dr
Melrose, MA 02176-3418
Phone (781) 307-0046
Other practice location 1
701 Warrenville Rd Ste 210
Lisle, IL 60532-1376
Phone (781) 307-0046
Other practice location 2
1 Constitution Wharf
Boston, MA 02129
Phone (781) 307-0046
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 |
|---|---|---|---|
| LDN7654 | MA | MD | Registered Dietitian |
| L008181 | NC | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1043031339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 WOODCREST DR",
"city": "MELROSE",
"state": "MA",
"postal_code": "021763418",
"telephone_number": "781-307-0046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "168 WOODCREST DR",
"city": "MELROSE",
"state": "MA",
"postal_code": "021763418",
"telephone_number": "781-307-0046"
}
],
"practiceLocations": [
{
"address_1": "701 Warrenville Rd Ste 210",
"address_purpose": "LOCATION",
"city": "Lisle",
"state": "IL",
"postal_code": "605321376",
"country_code": "US",
"telephone_number": "781-307-0046",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Constitution Wharf",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "02129",
"country_code": "US",
"telephone_number": "781-307-0046",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HICKEY",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"credential": "RDN LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-21",
"last_updated": "2024-10-23",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L008181",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "LDN7654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melrose, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.