Active NPI
Audrey Boutcher, RDN
- Registered Dietitian
- Essex Fells, NJ
National Provider Identifier
1275222549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 169 Devon Rd
Essex Fells, NJ 07021-1716 - Phone
- (201) 953-2693
- NPI assigned
- May 3, 2023
- Last updated
- May 3, 2023
- 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 | Primary |
Addresses
Primary practice location
169 Devon Rd
Essex Fells, NJ 07021-1716
Mailing address
169 Devon Rd
Essex Fells, NJ 07021-1716
Phone (201) 953-2693
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1683072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683072000000",
"number": "1275222549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 DEVON RD",
"city": "ESSEX FELLS",
"state": "NJ",
"postal_code": "070211716",
"telephone_number": "201-953-2693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 DEVON RD",
"city": "ESSEX FELLS",
"state": "NJ",
"postal_code": "070211716",
"telephone_number": "201-953-2693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUTCHER",
"first_name": "AUDREY",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-03",
"last_updated": "2023-05-03",
"certification_date": "2023-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Essex Fells, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.