Active NPI
Christina J. Chan
- Registered Dietitian
- Cambridge, MA
National Provider Identifier
1386214997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 5172
- Practice address
- 106 Winthrop St
Cambridge, MA 02138-4930 - Phone
- (617) 982-3933
- NPI assigned
- Jun 26, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 5172 | MA | Primary |
Addresses
Primary practice location
106 Winthrop St
Cambridge, MA 02138-4930
Mailing address
11 Scottfield Rd Apt 3
Allston, MA 02134-3710
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5172 | MA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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": "1624665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624665600000",
"number": "1386214997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SCOTTFIELD RD APT 3",
"city": "ALLSTON",
"state": "MA",
"postal_code": "021343710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 WINTHROP ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384930",
"telephone_number": "617-982-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "CHRISTINA",
"middle_name": "J.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-26",
"last_updated": "2021-06-26",
"certification_date": "2021-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "5172",
"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 Jun 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.