Individual provider Active NPI

Anne McRae Mittnacht, MPH, RD, LDN, CEDRD

  • Registered Dietitian
  • Burlington, MA
National Provider Identifier
1265974729
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LDN4425 Issued in MA
Practice address
111 Middlesex Tpke # 1107
Burlington, MA 01803-4905
Phone
(617) 942-4363
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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 LDN4425 MA Primary

Addresses

Primary practice location

111 Middlesex Tpke # 1107
Burlington, MA 01803-4905

Mailing address

680 Ideal Way
Charlotte, NC 28203-5625
Phone (609) 577-6791

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LDN4425MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Mittnacht Nutrition Counseling LLC Dietitian, Registered CurrentSince Feb 11, 2024 Accepting new patients

Locations

111 Middlesex Tpke
#1107
Burlington, MA 01803
Phone (617) 942-4363

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.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1265974729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 IDEAL WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035625",
            "telephone_number": "609-577-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MIDDLESEX TPKE # 1107",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034905",
            "telephone_number": "617-942-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTNACHT",
        "first_name": "ANNE",
        "middle_name": "MCRAE",
        "name_prefix": "Ms.",
        "credential": "MPH, RD, LDN, CEDRD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "LDN4425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.