Dietetic Associates, Inc.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

DIETETIC ASSOCIATES, INC.

Practice address

12376 Carroll Dr
Chardon, OH 44024-9444

Phone

(440) 487-8717

Fax

(866) 200-2885

NPI assigned

Mar 7, 2020

Organization subpart

No

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

Authorized official

Name

Cora Martin, RDN, CSG, LD

Title

President

Phone

(440) 487-8717

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583539200000",
    "number": "1275168544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12376 CARROLL DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440249444",
            "telephone_number": "440-487-8717",
            "fax_number": "866-200-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12376 CARROLL DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440249444",
            "telephone_number": "440-487-8717",
            "fax_number": "866-200-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETETIC ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CORA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-487-8717",
        "authorized_official_credential": "RDN, CSG, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Gerontological",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Chardon, OH
• Providers in Chardon, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.