Carolyn Allen, RD, CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

008357 Issued in NY

Practice address

4500 Pewter LN BLDG 8&9
Manlius, NY 13104-9707

Phone

(315) 683-4263

NPI assigned

Jul 18, 2017

Last updated

Dec 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Rural Roots Nutrition PLLC

  • Home Health Agency
  • Fabius, NY
  • NPI 1285143651
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1356864771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1672 POMPEY CENTER RD",
            "city": "FABIUS",
            "state": "NY",
            "postal_code": "130638703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PEWTER LN BLDG 8&9",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049707",
            "telephone_number": "315-683-4263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1672 Pompey Center Road",
            "address_purpose": "LOCATION",
            "city": "Fabius",
            "state": "NY",
            "postal_code": "13062",
            "country_code": "US",
            "telephone_number": "607-222-0447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "CAROLYN",
        "credential": "RD, CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "008357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Steven Adamczyk, PHARM D
• Deirdre Affleck, MS, LMHC
• Christine Aiello, M.S
• Abosede Nihinlola Alao, RN, BSN , MSN
• Alcohol Services Inc
• Lori L Anderson, MD
• Desta Rowena Anthony, ANP
• Paraskos Araouzos, MD
• Damond P Archung, PT
• Hannah Aubertine, LMHC

• Registered Dietitian in Manlius, NY
• Providers in Manlius, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.