Organization Active NPI

Jean Green

  • Registered Dietitian
  • Shrewsbury, MA
National Provider Identifier
1164593224
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
843 Issued in MA
Legal business name
JEAN GREEN
Practice address
588 Main St
Shrewsbury, MA 01545-2920
Phone
(509) 393-1920
NPI assigned
Nov 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Jean Green
Title
Owner
Phone
(508) 393-1920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 843 MA Primary

Addresses

Primary practice location

588 Main St
Shrewsbury, MA 01545-2920

Mailing address

50 Cherry St
Northborough, MA 01532-1209
Phone (508) 393-1920

Other identifiers 3

IdentifierTypeStateIssuer
LD0054OtherMABLUECROSS BLUESHIELD ID
39221OtherMAHARVARD PILGRIM ID
725391OtherMATUFTS PROVIDER ID

National Provider Directory

National Provider Directory

Locations

1 Meeting House Rd
Ste 16
Chelmsford, MA 01824
Phone 9782561288205

588 Main St
Shrewsbury, MA 01545
Phone (310) 880-8889

4 Bellows Rd
Westborough, MA 01581

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1164593224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CHERRY ST",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015321209",
            "telephone_number": "508-393-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 MAIN ST",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015452920",
            "telephone_number": "509-393-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN GREEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-12",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-393-1920"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD ID",
            "identifier": "LD0054",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM ID",
            "identifier": "39221",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PROVIDER ID",
            "identifier": "725391",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.