Dorie Ellen Obertello, RD, LDN

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

DN005831 Issued in PA

Practice address

160 E Erie Ave
Department of Clinical Nutrition
Philadelphia, PA 19134-1011

Phone

(215) 427-3823

NPI assigned

Jun 17, 2016

Last updated

Jun 17, 2016By 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

Enrolled in MD

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kennedy Krieger Associates

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1871515783
  Medicare reassignment NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Middle River, MD
  • NPI 1841009842
  NPD

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1174973440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "address_2": "DEPARTMENT OF CLINICAL NUTRITION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "address_2": "DEPARTMENT OF CLINICAL NUTRITION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERTELLO",
        "first_name": "DORIE",
        "middle_name": "ELLEN",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "PA",
            "license": "DN005831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karl Gunnar Oberg, MD
• Tonja Kae Oberhansli, CRNA
• Amber Oberholzer
• Maureen Oberle, O.D.
• Sarena Oberoi
• Thomas Obi-Tabot, PT, DPT
• Paschal Chika Obi, MSW
• Louisa N. Obiesie, PH.D., NCC, LPC
• Nicholas Obiri, MD
• Rasika Obla

• Pediatric Nutrition Registered Dietitian in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nutrition Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.