Individual provider Active NPI

Deborah Bonzo, MS, RD, CDN

  • Registered Dietitian
  • Fairport, NY
National Provider Identifier
1174920714
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1060 Turk Hill Rd
Fairport, NY 14450-8758
Phone
(585) 802-7415
NPI assigned
Nov 25, 2014
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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 NU Primary

Addresses

Primary practice location

1060 Turk Hill Rd
Fairport, NY 14450-8758

Mailing address

1060 Turk Hill Rd
Fairport, NY 14450-8758
Phone (585) 802-7415

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1174920714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 TURK HILL RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508758",
            "telephone_number": "585-802-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 TURK HILL RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508758",
            "telephone_number": "585-802-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONZO",
        "first_name": "DEBORAH",
        "credential": "MS, RD, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.