Active NPI
Elizabeth Ann Wiggin, MDA, RD, LDN
- Registered Dietitian
- Roslindale, MA
National Provider Identifier
1215696455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3842
- Practice address
- 1200 Centre St
Roslindale, MA 02131-1000 - Phone
- (617) 363-8245
- NPI assigned
- Dec 15, 2021
- 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 | 3842 | MA | Primary |
Addresses
Primary practice location
1200 Centre St
Roslindale, MA 02131-1000
Mailing address
1200 Centre St
Roslindale, MA 02131-1000
Phone (617) 363-8245
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
- Medical Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3842 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1215696455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CENTRE ST",
"city": "ROSLINDALE",
"state": "MA",
"postal_code": "021311000",
"telephone_number": "617-363-8245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 CENTRE ST",
"city": "ROSLINDALE",
"state": "MA",
"postal_code": "021311000",
"telephone_number": "617-363-8245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGIN",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MDA, RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-15",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "3842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roslindale, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.