Active NPI
Debra K Brown-Grossman, RD
- Registered Dietitian
- Montclair, NJ
National Provider Identifier
1386691814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 540463
- Practice address
- 62 S Fullerton Ave
Montclair, NJ 07042-2629 - Phone
- (973) 655-1335
- Fax
- (973) 655-1336
- NPI assigned
- May 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 540463 | NJ | Primary |
Addresses
Primary practice location
62 S Fullerton Ave
Montclair, NJ 07042-2629
Mailing address
17 Berkshire Rd
Maplewood, NJ 07040-1427
Phone (973) 665-1335
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 540463 | NJ | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marjorie Nolan Cohn LLC | 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": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1386691814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 BERKSHIRE RD",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070401427",
"telephone_number": "973-665-1335",
"fax_number": "973-655-1336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 S FULLERTON AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422629",
"telephone_number": "973-655-1335",
"fax_number": "973-655-1336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN-GROSSMAN",
"first_name": "DEBRA",
"middle_name": "K",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-30",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NJ",
"license": "540463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.