Active NPI
Bridgitte Carroll, M.S., R.D.N., L.D.N.
- Registered Dietitian
- Cambridge, MA
National Provider Identifier
1376082479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4165
- Practice address
- 342 Broadway
Cambridge, MA 02139-1843 - Phone
- (419) 320-8687
- NPI assigned
- Feb 22, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LDN00887 | RI | |
| Registered Dietitian | 133V00000X | 4165 | MA | Primary |
Addresses
Primary practice location
342 Broadway
Cambridge, MA 02139-1843
Mailing address
342 Broadway
Cambridge, MA 02139-1843
Phone (419) 320-8687
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN00887 | RI | MD | Registered Dietitian |
| 4165 | MA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1376082479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "342 BROADWAY",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391843",
"telephone_number": "419-320-8687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "342 BROADWAY",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391843",
"telephone_number": "419-320-8687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "BRIDGITTE",
"credential": "M.S., R.D.N., L.D.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-22",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "RI",
"license": "LDN00887",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.