Mount Auburn Athletic Club, Inc.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

MOUNT AUBURN ATHLETIC CLUB, INC.

Practice address

57 Coolidge Ave
Watertown, MA 02472-2802

Phone

(617) 923-0055

Fax

(617) 812-8016

NPI assigned

Jun 27, 2014

Organization subpart

No

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

Authorized official

Name

Paul Crowley

Title

Executive Director

Phone

(617) 923-0055

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julie A Jacobsen, MS, RD, LDN

  • Registered Dietitian
  • Watertown, MA
  • NPI 1245639285

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1083029094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 COOLIDGE AVE",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722802",
            "telephone_number": "617-923-0055",
            "fax_number": "617-812-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 COOLIDGE AVE",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722802",
            "telephone_number": "617-923-0055",
            "fax_number": "617-812-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT AUBURN ATHLETIC CLUB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-27",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "CROWLEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "617-923-0055"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Morton, LICSW
• Zachary Moses, LICSW
• Rita R Moss, LICSW
• Fatema Mostafa
• Sejal R. Motwane, PHARMD
• Mount Auburn Hospital (Mount Auburn Home Care)
• Mount Auburn Physical Therapy Associates, PC
• Ms Orthodontics Associates LLC (Watertown Orthodontics)
• Mt Auburn Professional OBGYN
• Mt Auburn Professional Services

• Registered Dietitian in Watertown, MA
• Providers in Watertown, MA by specialty
• Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.