Active NPI
Michelle Lynn Krueger, MS, RD, CDE
- Registered Dietitian
- West Roxbury, MA
National Provider Identifier
1184638371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2452
- Practice address
- 1400 VFW Pkwy
West Roxbury, MA 02132-4927 - Phone
- (857) 203-5108
- NPI assigned
- Jul 27, 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 | 2452 | MA | Primary |
Addresses
Primary practice location
1400 VFW Pkwy
West Roxbury, MA 02132-4927
Mailing address
60 Knollwood Cir
Weymouth, MA 02188-2211
Phone (857) 203-5108
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2452 | Other | MA | DIETITIAN STATE LICENSE |
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2452 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184638371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 KNOLLWOOD CIR",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021882211",
"telephone_number": "857-203-5108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 VFW PKWY",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021324927",
"telephone_number": "857-203-5108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEGER",
"first_name": "MICHELLE",
"middle_name": "LYNN",
"credential": "MS, RD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "2452",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIETITIAN STATE LICENSE",
"identifier": "2452",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.