Active NPI
Anna Jasonides, RD
- Registered Dietitian
- Cambridge, MA
National Provider Identifier
1174598957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 723922
- Practice address
- 77 Mass Ave
Medical E23-395
Cambridge, MA 02139-4301 - Phone
- (617) 253-0556
- NPI assigned
- Feb 23, 2006
- 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 | 723922 | MA | Primary |
Addresses
Primary practice location
77 Mass Ave
Medical E23-395
Cambridge, MA 02139-4301
Mailing address
PO Box 425789
Medical E23-395
Cambridge, MA 02142-0015
Phone (617) 253-0556
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 |
|---|---|---|---|
| 1336 | MA | MD | Addiction (Substance Use Disorder) Counselor |
| 723922 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450828800000",
"number": "1174598957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 425789",
"address_2": "MEDICAL E23-395",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021420015",
"telephone_number": "617-253-0556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 MASS AVE",
"address_2": "MEDICAL E23-395",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021394301",
"telephone_number": "617-253-0556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASONIDES",
"first_name": "ANNA",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2015-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "723922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.