Active NPI
Caroline Marie Desanctis, RD, LDN
- Registered Dietitian
- Mount Laurel, NJ
National Provider Identifier
1053862243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 04116163
- Practice address
- 15000 Midlantic Dr
Suite 101
Mount Laurel, NJ 08054-1573 - Phone
- (800) 736-3739
- Fax
- (856) 778-0636
- NPI assigned
- Oct 22, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 04116163 | PA | Primary |
Addresses
Primary practice location
15000 Midlantic Dr
Suite 101
Mount Laurel, NJ 08054-1573
Mailing address
501 W 14TH St
Wilmington, DE 19801-1013
Phone (215) 840-6310
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04116163 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1053862243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 W 14TH ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198011013",
"telephone_number": "215-840-6310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15000 MIDLANTIC DR",
"address_2": "SUITE 101",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080541573",
"telephone_number": "800-736-3739",
"fax_number": "856-778-0636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANCTIS",
"first_name": "CAROLINE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-22",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "04116163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Laurel, NJ
- Diane Marie Denning, O.D.
- Anthony M. Depasquale, LICENSE PSYCHOLOGIST
- Veronica Depinto
- Dermatology Associates of South Jersey, L.L.C.
- Dermatology Physicians of South Jersey, PA
- Joshua Peter Desipio, M.D.
- Larry Deutsch, M.D.
- Rebekah Dietrich, DO
- Difiore Enterprises Inc. (Optique Boutique)
- Paul D Difiore, OD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.