Cheryl Muriel Brock, RD, LDN

Individual provider Active NPI Registered Dietitian · Smithfield, RI

NPI 1225751167 · NPPES record last updated Sep 26, 2022

Key facts

NPI
1225751167
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LDN00484 (RI)
Practice address
1150 Douglas Pike
Smithfield, RI 02917-1291
Phone
(401) 232-6221
Fax
(401) 232-6702
NPI assigned
Sep 26, 2022
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LDN00484RIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Rachel Tenuta Rd Dietitian, Registered Past
since Jan 8, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian
Group: 193400000X SINGLE SPECIALTY GROUP
133V00000X LDN00484 RI Yes

Addresses

Primary practice location

1150 Douglas Pike
Smithfield, RI 02917-1291

Mailing address

52 Whispering Pine TRL
Wakefield, RI 02879-4544
Phone (401) 474-5850

Other practice location 1

110 Main St
East Greenwich, RI 02818-3880
Phone (917) 797-8938

Other providers in Smithfield, RI

All providers in Smithfield, RI · Registered Dietitian in Rhode Island

Sources for this page

Verify at the official NPI Registry.