Individual provider Active NPI

Melissa Bondurich, RD, LDN

  • Registered Dietitian
  • Allentown, PA
National Provider Identifier
1124633391
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN007172 Issued in PA
Practice address
1627 Chew St FL 3
Allentown, PA 18102-3648
Phone
(908) 887-1949
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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 DN007172 PA Primary

Addresses

Primary practice location

1627 Chew St FL 3
Allentown, PA 18102-3648

Mailing address

1627 Chew St FL 3
Allentown, PA 18102-3648

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
DN007172PAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1124633391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 CHEW ST FL 3",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 CHEW ST FL 3",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023648",
            "telephone_number": "908-887-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDURICH",
        "first_name": "MELISSA",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN007172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.