Individual provider Active NPI

Joanne Ryczak, RD CDE LDN

  • Registered Dietitian
  • Peckville, PA
National Provider Identifier
1104042043
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN000809 Issued in PA
Practice address
1400 Main St
Mid Valley Hospital
Peckville, PA 18452
Phone
(570) 383-5622
Fax
(570) 383-5603
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN000809 PA Primary

Addresses

Primary practice location

1400 Main St
Mid Valley Hospital
Peckville, PA 18452

Mailing address

203 Hospital St
Peckville, PA 18452-1125
Phone (570) 383-5622

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
DN000809PAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104042043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 HOSPITAL ST",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184521125",
            "telephone_number": "570-383-5622",
            "fax_number": "570-383-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MAIN ST",
            "address_2": "MID VALLEY HOSPITAL",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "18452",
            "telephone_number": "570-383-5622",
            "fax_number": "570-383-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYCZAK",
        "first_name": "JOANNE",
        "credential": "RD CDE LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN000809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peckville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.