Active NPI
Lynn Ellen Przystac, RDN, LDN
- Registered Dietitian
- Providence, RI
National Provider Identifier
1104452747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN00217
- Practice address
- 101 Dudley St Dept of
Providence, RI 02905-2499 - Phone
- (401) 274-1122
- Fax
- (401) 453-7572
- NPI assigned
- Mar 16, 2020
- Sex
- Female
- Sole proprietor
- No
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 | LDN00217 | RI | Primary |
Addresses
Primary practice location
101 Dudley St Dept of
Providence, RI 02905-2499
Mailing address
101 Dudley St Dept of
Providence, RI 02905-2499
Phone (401) 274-1122
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Warwick, RI
- NPI 1184944662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584316800000",
"number": "1104452747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 DUDLEY ST DEPT OF",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029052499",
"telephone_number": "401-274-1122",
"fax_number": "401-453-7572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 DUDLEY ST DEPT OF",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029052499",
"telephone_number": "401-274-1122",
"fax_number": "401-453-7572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRZYSTAC",
"first_name": "LYNN",
"middle_name": "ELLEN",
"credential": "RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-16",
"last_updated": "2020-03-16",
"certification_date": "2020-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "RI",
"license": "LDN00217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.