Individual provider Active NPI

Jamie Halcom

  • Registered Dietitian
  • Old Greenwich, CT
National Provider Identifier
1053767657
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1000003 Issued in CT
Practice address
1445 E Putnam Ave
Old Greenwich, CT 06870-1379
Phone
(203) 835-5020
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
1000003CTMDRegistered Dietitian

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1000003 CT Primary

Addresses

NPPES NPI Registry

Primary practice location

1445 E Putnam Ave
Old Greenwich, CT 06870-1379

Mailing address

1445 E Putnam Ave
Old Greenwich, CT 06870-1379

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 12, 2016.

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1053767657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 E PUTNAM AVE",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068701379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 E PUTNAM AVE",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068701379",
            "telephone_number": "203-835-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALCOM",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "1000003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.