Individual provider Active NPI

Denise R. Foresman, MS, RDN, LDN

  • Registered Dietitian
  • Gardner, MA
National Provider Identifier
1063543924
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1788 Issued in MA
Practice address
242 Green St
Gardner, MA 01440-1336
Phone
(978) 630-6822
Fax
(978) 630-6820
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1788 MA
Registered Dietitian 133V00000X 722185 MA
Registered Dietitian 133V00000X 1788 MA Primary

Addresses

Primary practice location

242 Green St
Gardner, MA 01440-1336

Mailing address

193 Pearl St
Winchendon, MA 01475-1164
Phone (978) 751-1586

Other identifiers 1

IdentifierTypeStateIssuer
1063543924MedicaidMA

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 Science

State licenses

LicenseStateTypeSpecialty
722185MAMDRegistered Dietitian
1788MAMDAthletic Trainer

Interoperability endpoints

  • Direct secure messaging: denise.foresman.p1@direct.chcfhc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1063543924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 PEARL ST",
            "city": "WINCHENDON",
            "state": "MA",
            "postal_code": "014751164",
            "telephone_number": "978-751-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-630-6822",
            "fax_number": "978-630-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORESMAN",
        "first_name": "DENISE",
        "middle_name": "R.",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MA",
            "license": "1788",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "722185",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "1788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063543924",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.

Verify at the official NPI Registry.