Active NPI
Nancy Brown, MSRD
- Registered Dietitian
- East Granby, CT
National Provider Identifier
1104247303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 000574
- Practice address
- 10 Heritage Farm Rd
East Granby, CT 06026-9677 - Phone
- (860) 651-8896
- NPI assigned
- Dec 16, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 000574 | CT | Primary |
Addresses
Primary practice location
10 Heritage Farm Rd
East Granby, CT 06026-9677
Mailing address
10 Heritage Farm Rd
East Granby, CT 06026-9677
Phone (860) 651-8896
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 270000574CT01 | Other | CT | ANTHEM |
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 |
|---|---|---|---|
| 3734 | MA | MD | Behavioral Analyst |
| 000574 | CT | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414540800000",
"number": "1104247303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 HERITAGE FARM RD",
"city": "EAST GRANBY",
"state": "CT",
"postal_code": "060269677",
"telephone_number": "860-651-8896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 HERITAGE FARM RD",
"city": "EAST GRANBY",
"state": "CT",
"postal_code": "060269677",
"telephone_number": "860-651-8896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "NANCY",
"credential": "MSRD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-16",
"last_updated": "2014-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CT",
"license": "000574",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "270000574CT01",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Granby, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.