Active NPI
Christine Charbonneau, RD
- Registered Dietitian
- Raynham, MA
National Provider Identifier
1275130247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4468
- Practice address
- 67 Sparrow Way
Raynham, MA 02767-6132 - Phone
- (508) 542-8878
- NPI assigned
- Oct 2, 2020
- Last updated
- Oct 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 4468 | MA | Primary |
Addresses
Primary practice location
67 Sparrow Way
Raynham, MA 02767-6132
Mailing address
67 Sparrow Way
Raynham, MA 02767-6132
Phone (508) 542-8878
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4468 | MA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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, 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": "1601596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601596800000",
"number": "1275130247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 SPARROW WAY",
"city": "RAYNHAM",
"state": "MA",
"postal_code": "027676132",
"telephone_number": "508-542-8878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 SPARROW WAY",
"city": "RAYNHAM",
"state": "MA",
"postal_code": "027676132",
"telephone_number": "508-542-8878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARBONNEAU",
"first_name": "CHRISTINE",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-02",
"last_updated": "2020-10-02",
"certification_date": "2020-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raynham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.