NPIMap

Organization Active NPI

Nourish for Life

  • Registered Dietitian
  • Cambridge, MA
National Provider Identifier
1245843440
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NOURISH FOR LIFE
Practice address
126 Prospect St Ste 6
Cambridge, MA 02139-2540
Phone
(617) 744-9233
Fax
(617) 300-8910
NPI assigned
Aug 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Heinen, MS, RDN, LDNNPI 1033547039
Title
Owner
Phone
(617) 744-9233

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

126 Prospect St Ste 6
Cambridge, MA 02139-2540

Mailing address

41 Harrington St
Watertown, MA 02472-1015
Phone (917) 692-8270

National Provider Directory

National Provider Directory

Locations

2557 Massachusetts Ave
Cambridge, MA 02140
Phone (617) 492-3185

126 Prospect St
Ste 6
Cambridge, MA 02139
Phone (617) 583-3269

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1245843440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 HARRINGTON ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024721015",
            "telephone_number": "917-692-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 PROSPECT ST STE 6",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021392540",
            "telephone_number": "617-744-9233",
            "fax_number": "617-300-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISH FOR LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "HEINEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-744-9233",
        "authorized_official_credential": "MS, RDN, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.