NPIMap

Organization Active NPI

Pioneer Valley Nutrition, Inc.

  • Registered Dietitian
  • Northampton, MA
National Provider Identifier
1336186873
Registry record updated May 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2232 Issued in MA
Legal business name
PIONEER VALLEY NUTRITION, INC.
Practice address
39 Carlon Dr
Northampton, MA 01060-2374
Phone
(413) 584-2200
Fax
(413) 584-2255
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2009

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

Authorized official

Name
Ms. Polly Ann Obremski, RD, LDN, CDE
Title
Owner
Phone
(413) 584-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 2232 MA Primary

Addresses

Primary practice location

39 Carlon Dr
Northampton, MA 01060-2374

Mailing address

39 Carlon Dr
Northampton, MA 01060-2374
Phone (413) 584-2200

Other identifiers 6

IdentifierTypeStateIssuer
4609501OtherMACIGNA NUMBER
MT0840OtherMAMEDICARE
11326384OtherMACAQH NUMBER
AA59459OtherMAHARVARD PILGRIM
LG0035OtherMABCBS GROUP NUMBER
35122OtherMAHEALTH NEW ENGLAND

National Provider Directory

National Provider Directory

Locations

247 Northampton St
Ste 8
Easthampton, MA 01027
Phone (413) 527-7676

39 Carlon Dr
Northampton, MA 01060
Phone (413) 584-2200

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242950400000",
    "number": "1336186873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 CARLON DR",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602374",
            "telephone_number": "413-584-2200",
            "fax_number": "413-584-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CARLON DR",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602374",
            "telephone_number": "413-584-2200",
            "fax_number": "413-584-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER VALLEY NUTRITION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2009-05-22",
        "status": "A",
        "authorized_official_last_name": "OBREMSKI",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-584-2200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD, LDN, CDE"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA NUMBER",
            "identifier": "4609501",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MT0840",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "11326384",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA59459",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "LG0035",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "35122",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; 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.