Active NPI
Charmaine Vincent Haan, RD
- Registered Dietitian
- Norton, MA
National Provider Identifier
1154488088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 355
- Practice address
- 84 Godfrey Dr
Norton, MA 02766-1368 - Phone
- (508) 952-2120
- NPI assigned
- Jan 2, 2007
- 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 | 355 | MA | Primary |
Addresses
Primary practice location
84 Godfrey Dr
Norton, MA 02766-1368
Mailing address
84 Godfrey Dr
Norton, MA 02766-1368
Phone (508) 952-2120
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LD0172 | Other | MA | BCBS PROVIDER |
| 494470 | Other | MA | TUFTS ANCILLARY PROVIDER |
| AA43414 | Other | MA | HARVARD-PILGRIM ANCILLARY |
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 |
|---|---|---|---|
| 355 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464739200000",
"number": "1154488088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 GODFREY DR",
"city": "NORTON",
"state": "MA",
"postal_code": "027661368",
"telephone_number": "508-952-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 GODFREY DR",
"city": "NORTON",
"state": "MA",
"postal_code": "027661368",
"telephone_number": "508-952-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAN",
"first_name": "CHARMAINE",
"middle_name": "VINCENT",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2016-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "355",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER",
"identifier": "LD0172",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS ANCILLARY PROVIDER",
"identifier": "494470",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD-PILGRIM ANCILLARY",
"identifier": "AA43414",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.