Individual provider Active NPI

Morgan Gosselin, RD

  • Registered Dietitian
  • South Boston, MA
National Provider Identifier
1356026090
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86212255 Issued in MA
Practice address
740 E 3Rd St Apt 3
South Boston, MA 02127-4515
Phone
(802) 498-3381
NPI assigned
Jun 20, 2023
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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 86212255 MA Primary

Addresses

Primary practice location

740 E 3Rd St Apt 3
South Boston, MA 02127-4515

Mailing address

740 E 3Rd St Apt 3
South Boston, MA 02127-4515
Phone (802) 498-3381

Other practice location 1

50 Tufts St
Somerville, MA 02145-4129
Phone (855) 655-7978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

302 Mountain View Dr
Suite 101
Colchester, VT 05446-5824

302 Mountain View Dr
Suite 101
Colchester, VT 05446-8081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86212255MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Feed the Wolf Weightlifting & Nutrition LLC Dietitian, Registered CurrentSince Jun 25, 2023 Accepting new patients

Locations

50 Tufts St
Somerville, MA 02145
Phone (617) 545-4472

Organizations & group practices 1

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1356026090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 E 3RD ST APT 3",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021274515",
            "telephone_number": "802-498-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 E 3RD ST APT 3",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021274515",
            "telephone_number": "802-498-3381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Tufts St",
            "address_purpose": "LOCATION",
            "city": "Somerville",
            "state": "MA",
            "postal_code": "021454129",
            "country_code": "US",
            "telephone_number": "855-655-7978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "MORGAN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "86212255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.