Individual provider Active NPI

Marcie Lee Fredenburg, RD, LDN

  • Registered Dietitian
  • Pittsfield, MA
National Provider Identifier
1326165580
Registry record updated Jun 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2342 Issued in MA
Practice address
725 North St
Pittsfield, MA 01201-4109
Phone
(413) 447-2000
Fax
(413) 447-2605
NPI assigned
Mar 23, 2007
Last updated
Jun 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2008

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 2342 MA Primary

Addresses

Primary practice location

725 North St
Pittsfield, MA 01201-4109

Mailing address

PO Box 1536
Lanesboro, MA 01237-1536
Phone (413) 445-5949

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2342MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Medical Center, Inc CurrentSince Jan 30, 2018 Accepting new patients
Berkshire Medical Center Inc. CurrentSince Jan 30, 2018 Accepting new patients

Locations

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214697600000",
    "number": "1326165580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1536",
            "city": "LANESBORO",
            "state": "MA",
            "postal_code": "012371536",
            "telephone_number": "413-445-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014109",
            "telephone_number": "413-447-2000",
            "fax_number": "413-447-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDENBURG",
        "first_name": "MARCIE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2008-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2008; 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.