Active NPI
Michelle Ly, RD
- Registered Dietitian
- Fitchburg, MA
National Provider Identifier
1225643182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4482
- Practice address
- 1361 Rindge Rd
Fitchburg, MA 01420-1323 - Phone
- (978) 516-4640
- NPI assigned
- Sep 8, 2020
- 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 | 4482 | MA | Primary |
Addresses
Primary practice location
1361 Rindge Rd
Fitchburg, MA 01420-1323
Mailing address
1361 Rindge Rd
Fitchburg, MA 01420-1323
Other practice location 1
130 Marshall Rd
Lowell, MA 01852-5130
Phone (978) 671-9118
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4482 | MA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutriteam LLC | Dietitian, Registered | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1225643182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1361 RINDGE RD",
"city": "FITCHBURG",
"state": "MA",
"postal_code": "014201323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1361 RINDGE RD",
"city": "FITCHBURG",
"state": "MA",
"postal_code": "014201323",
"telephone_number": "978-516-4640"
}
],
"practiceLocations": [
{
"address_1": "130 Marshall Rd",
"address_purpose": "LOCATION",
"city": "Lowell",
"state": "MA",
"postal_code": "018525130",
"country_code": "US",
"telephone_number": "978-671-9118",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LY",
"first_name": "MICHELLE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-08",
"last_updated": "2023-06-02",
"certification_date": "2023-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fitchburg, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.