Organization Active NPI

Shared Nutrition, LLC

  • Registered Dietitian
  • Brighton, MA
National Provider Identifier
1265253066
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SHARED NUTRITION, LLC
Practice address
1660 Soldiers Field Road
Suite 7 1167
Brighton, MA 02135
Phone
(617) 763-6331
NPI assigned
Oct 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Suzanne Brodney, PHD, MS, RDNNPI 1295888519
Title
Owner
Phone
(401) 345-1809

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

1660 Soldiers Field Road
Suite 7 1167
Brighton, MA 02135

Mailing address

1660 Soldiers Field Rd Ste 71167
Brighton, MA 02135-1108
Phone (617) 763-6331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250627000169 MA Part B Supplier - Clinic/Group Practice 3476066127 Receives reassigned benefits from 1 practitioner
Practice locations: Brighton, MA

National Provider Directory

National Provider Directory

Locations

1660 Soldiers Field Rd
#1167
Brighton, MA 02135
Phone (617) 763-6331

1660 Soldiers Field Rd
Ste 71167
Brighton, MA 02135

Practitioners & affiliated clinicians

Practitioners 1

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": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1265253066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 SOLDIERS FIELD RD STE 71167",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021351108",
            "telephone_number": "617-763-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 SOLDIERS FIELD ROAD",
            "address_2": "SUITE 7 1167",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-763-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARED NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "BRODNEY",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-345-1809",
        "authorized_official_credential": "PHD, MS, RDN"
    },
    "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 Brighton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.