Active NPI
Nancy Lynn Depalo, RD
- Registered Dietitian
- Northport, NY
National Provider Identifier
1184724460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 79 Middleville Rd
VA Medical Center
Northport, NY 11768 - Phone
- (631) 261-4400
- NPI assigned
- Sep 25, 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 | Primary |
Addresses
Primary practice location
79 Middleville Rd
VA Medical Center
Northport, NY 11768
Mailing address
535 Race Place
Oakdale, NY 11769
Phone (631) 218-9808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R436861 | Other | AMER DIETETIC ASSOC CDR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184724460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 RACE PLACE",
"city": "OAKDALE",
"state": "NY",
"postal_code": "11769",
"telephone_number": "631-218-9808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 MIDDLEVILLE RD",
"address_2": "VA MEDICAL CENTER",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "11768",
"telephone_number": "631-261-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEPALO",
"first_name": "NANCY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMER DIETETIC ASSOC CDR",
"identifier": "R436861",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Northport, NY
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.