Autumn L Mastroianni, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2119 Issued in KY

Practice address

843 Fairview Ave
Suite B6
Bowling Green, KY 42101-4914

Phone

(270) 901-3412

Fax

(270) 901-3413

NPI assigned

Mar 20, 2012

Last updated

Mar 20, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1174898456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 FAIRVIEW AVE",
            "address_2": "SUITE B6",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014914",
            "telephone_number": "270-901-3412",
            "fax_number": "270-901-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 FAIRVIEW AVE",
            "address_2": "SUITE B6",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014914",
            "telephone_number": "270-901-3412",
            "fax_number": "270-901-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROIANNI",
        "first_name": "AUTUMN",
        "middle_name": "L",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "2119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick A Mason, LMFT
• Joe Todd Mason, MSPT
• Scott P Mason
• Latango Ann Massey
• Hailey Masterson
• Diego Mastronardi, M.D.
• Melissa Mathews, PH.D
• Destiny Mathis
• Leigh Ann Mathis
• Marley Catherine Mathis

• Registered Dietitian in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Registered Dietitian in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.