Individual provider Active NPI

Jeanne Marie Spellman, RD

  • Registered Dietitian
  • Boston, MA
National Provider Identifier
1043583792
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3140 Issued in MA
Practice address
330 Brookline Ave
General Medicine Yamins 111
Boston, MA 02215-5400
Phone
(617) 667-7000
Fax
(617) 667-9105
NPI assigned
Feb 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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 3140 MA Primary

Addresses

Primary practice location

330 Brookline Ave
General Medicine Yamins 111
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
General Medicine Yamins 111
Boston, MA 02215-5400
Phone (617) 667-7000

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

State licenses

LicenseStateTypeSpecialty
3140MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1043583792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "GENERAL MEDICINE YAMINS 111",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-7000",
            "fax_number": "617-667-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "GENERAL MEDICINE YAMINS 111",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-7000",
            "fax_number": "617-667-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLMAN",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "3140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.