Individual provider Active NPI

Diane Bussolini, R.D. CDE

  • Registered Dietitian
  • Farmington, CT
National Provider Identifier
1306168489
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000532 Issued in CT
Practice address
20 Batterson Park Rd
Farmington, CT 06032-4502
Phone
(877) 676-7700
NPI assigned
Feb 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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 000532 CT Primary

Addresses

Primary practice location

20 Batterson Park Rd
Farmington, CT 06032-4502

Mailing address

20 Batterson Park Rd
Farmington, CT 06032-4502
Phone (877) 676-7700

Other identifiers 1

IdentifierTypeStateIssuer
000532OtherCTLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100517000124 CT Practitioner - Registered Dietitian Or Nutrition Professional 2264560960 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Sep 25, 2023 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Sep 25, 2023 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

1300 Hall Blvd
Bloomfield, CT 06002

95 Woodland St
Hartford, CT 06105
Phone (860) 677-6143

95 Woodland St
Fl 1
Hartford, CT 06105
Phone (860) 714-7362

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1306168489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BATTERSON PARK RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060324502",
            "telephone_number": "877-676-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BATTERSON PARK RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060324502",
            "telephone_number": "877-676-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSOLINI",
        "first_name": "DIANE",
        "credential": "R.D. CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "000532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "000532",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.