Individual provider Active NPI

Michelle Van Gombos, RD, LDN

  • Registered Dietitian
  • Dover, NH
National Provider Identifier
1255938825
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
15 Old Rollinsford Rd
Dover, NH 03820-2868
Phone
(603) 740-2647
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NH Primary

Addresses

Primary practice location

15 Old Rollinsford Rd
Dover, NH 03820-2868

Mailing address

59 Alderwood Dr
Stratham, NH 03885-4205
Phone (603) 247-1013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016004774 NH Practitioner - Registered Dietitian Or Nutrition Professional 2668904574 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Hospital Current Accepting new patients
Wentworth Douglass Hospital CurrentSince Aug 10, 2024 Accepting new patients
Wentworth Douglass Hospital CurrentSince Aug 10, 2024 Accepting new patients

Locations

15 Rollinsford Rd
Dover, NH 03820
Phone (603) 742-3664

73 Corporate Dr
Bldg B
Portsmouth, NH 03801
Phone (603) 610-8058

Organizations & group practices 3

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1255938825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ALDERWOOD DR",
            "city": "STRATHAM",
            "state": "NH",
            "postal_code": "038854205",
            "telephone_number": "603-247-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OLD ROLLINSFORD RD",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202868",
            "telephone_number": "603-740-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN GOMBOS",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.