Ilene B Siegel, RD

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

074-0000033 Issued in VT

Practice address

130 Fisher Rd
Berlin, VT 05602-9516

Phone

(802) 371-4152

Fax

(802) 371-4572

NPI assigned

Apr 2, 2007

Last updated

Oct 24, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1306967054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "ATT: CVMC FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-371-4152",
            "fax_number": "802-371-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029516",
            "telephone_number": "802-371-4152",
            "fax_number": "802-371-4572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "ILENE",
        "middle_name": "B",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "VT",
            "license": "074-0000033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022299",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "28599",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaws Supermarkets Inc (Shaws Pharmacy #0616)
• Harriott Meyer Shea, MD
• Jessica Shedd, FNP-BC
• Holly D. Shephard, LCMHC
• Jessica R Sherman, AGPCNP-BC
• James Siegel, BA
• Devika Singh, M.D.
• Priyanka Singh, M.D.
• Sarah Sliva, MD
• Scott Alan Small, PA-C

• Nutrition Education Nutritionist in Berlin, VT
• Providers in Berlin, VT by specialty
• Nutrition Education Nutritionist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.