Active NPI
Prema Ganganna, RDN
- Registered Dietitian
- Rockville, MD
National Provider Identifier
1235609397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D1451
- Practice address
- 14995 Shady Grove Rd Ste 100
Rockville, MD 20850-8733 - Phone
- (301) 869-7820
- NPI assigned
- Dec 3, 2018
- 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 | D1451 | DC | Primary |
Addresses
Primary practice location
14995 Shady Grove Rd Ste 100
Rockville, MD 20850-8733
Mailing address
14995 Shady Grove Rd Ste 100
Rockville, MD 20850-8733
Phone (301) 869-7820
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D1451 | DC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543795200000",
"number": "1235609397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14995 SHADY GROVE RD STE 100",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208508733",
"telephone_number": "301-869-7820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14995 SHADY GROVE RD STE 100",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208508733",
"telephone_number": "301-869-7820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANGANNA",
"first_name": "PREMA",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-03",
"last_updated": "2018-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "DC",
"license": "D1451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.