Individual provider Active NPI

Jodi-Ann Surrey-Smith, R.D.,L.D.N.

  • Registered Dietitian
  • Raynham, MA
National Provider Identifier
1356528772
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
791 Issued in MA
Practice address
88 Katherines Way
Raynham, MA 02767-1574
Phone
(508) 822-8548
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 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 791 MA Primary

Addresses

Primary practice location

88 Katherines Way
Raynham, MA 02767-1574

Mailing address

88 Katherines Way
Raynham, MA 02767-1574
Phone (508) 822-8548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210312001486 MA Practitioner - Registered Dietitian Or Nutrition Professional 5193131365 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
791MAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Pediatric Associates Inc CurrentSince Dec 8, 2020 Accepting new patients

Locations

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1356528772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 KATHERINES WAY",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671574",
            "telephone_number": "508-822-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 KATHERINES WAY",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671574",
            "telephone_number": "508-822-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURREY-SMITH",
        "first_name": "JODI-ANN",
        "credential": "R.D.,L.D.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raynham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.