Virginia L Paine, RD, CDOE

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

RN18730 Issued in RI

Practice address

900 Warren Ave Ste 100
East Providence, RI 02914-1430

Phone

(401) 383-9662

Fax

(401) 383-6526

NPI assigned

Aug 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1063760130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 GOLD MINE RD",
            "city": "CHEPACHET",
            "state": "RI",
            "postal_code": "028141758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WARREN AVE STE 100",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141430",
            "telephone_number": "401-383-9662",
            "fax_number": "401-383-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINE",
        "first_name": "VIRGINIA",
        "middle_name": "L",
        "credential": "RD, CDOE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN18730",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "RI",
            "license": "RN18730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1063760130",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; 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.