Individual provider Active NPI

Debra Anne Vincent, MA ,RDN,CDOE,CVDOE

  • Registered Dietitian
  • Cranston, RI
National Provider Identifier
1053485185
Registry record updated Oct 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
676708 Issued in RI
Practice address
63 Sockanosset Cross Rd
Suite a
Cranston, RI 02920-5557
Phone
(401) 426-0018
Fax
(401) 944-1812
NPI assigned
Nov 20, 2006
Last updated
Oct 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 676708 RI Primary
Registered Dietitian 133V00000X LDN00057 RI

Addresses

Primary practice location

63 Sockanosset Cross Rd
Suite a
Cranston, RI 02920-5557

Mailing address

100 Twin Birch Dr
Cranston, RI 02921-7512
Phone (401) 426-0018

Other identifiers 2

IdentifierTypeStateIssuer
403156OtherRIBLUE CHIP
256106OtherRIRI BLUE CROSS

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
676708RIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Neuro Behavioral Care LLC PastSince Oct 24, 2019 Accepting new patients
Women's Internal Medicine Inc. PastSince Mar 1, 2002 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3039/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476489600000",
    "number": "1053485185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TWIN BIRCH DR",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029217512",
            "telephone_number": "401-426-0018",
            "fax_number": "401-944-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SOCKANOSSET CROSS RD",
            "address_2": "SUITE A",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205557",
            "telephone_number": "401-426-0018",
            "fax_number": "401-944-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "DEBRA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MA ,RDN,CDOE,CVDOE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "RI",
            "license": "676708",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "RI",
            "license": "LDN00057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "403156",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CROSS",
            "identifier": "256106",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2016; 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.