Individual provider Active NPI

Kathryn Anne Janeczek

  • Registered Dietitian
  • Concord, MA
National Provider Identifier
1275009516
Registry record updated Oct 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4671-NU-NU Issued in MA
Practice address
57 Old Road to 9 Acre Cor
Concord, MA 01742-3317
Phone
(978) 846-2901
NPI assigned
Oct 14, 2018
Last updated
Oct 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2018

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 4671-NU-NU MA Primary

Addresses

Primary practice location

57 Old Road to 9 Acre Cor
Concord, MA 01742-3317

Mailing address

1 Indigo LN
Westford, MA 01886-4042
Phone (978) 846-2901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223002676 MA Practitioner - Registered Dietitian Or Nutrition Professional 1355744053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

317 6TH Ave
Suite 400
Des Moines, IA 50309-4037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4671-NU-NUMAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners PC Dietitian, Registered CurrentSince Oct 13, 2025 Accepting new patients
Inspired Nutrition and Health Dietitian, Registered CurrentSince Jul 25, 2019 Accepting new patients
Openloop Healthcare Partners New Jersey PC Dietitian, Registered Past Accepting new patients
Openloop Healthcare Partners California PC Dietitian, Registered Past Accepting new patients

Locations

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

155 Federal St
Ste 700
Boston, MA 02110
Phone (469) 466-7420

57 Old Road To 9 Acre Cor
Concord, MA 01742
Phone (508) 245-9338

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1539475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539475200000",
    "number": "1275009516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDIGO LN",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018864042",
            "telephone_number": "978-846-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423317",
            "telephone_number": "978-846-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANECZEK",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-14",
        "last_updated": "2018-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "4671-NU-NU",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.