Active NPI
Elizabeth Pearl, RD LDN
- Registered Dietitian
- Lexington, MA
National Provider Identifier
1386775898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1024
- Practice address
- 33 Bedford St
Suite 20
Lexington, MA 02420-4319 - Phone
- (781) 674-1189
- Fax
- (781) 863-2646
- NPI assigned
- Mar 8, 2007
- 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 | 1024 | MA | Primary |
Addresses
Primary practice location
33 Bedford St
Suite 20
Lexington, MA 02420-4319
Mailing address
33 Bedford St
Suite 20
Lexington, MA 02420-4319
Phone (781) 674-1189
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000ICM134 | Other | MA | BCBS |
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 |
|---|---|---|---|
| 1024 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whole Life Nutrition, 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": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386775898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 BEDFORD ST",
"address_2": "SUITE 20",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024204319",
"telephone_number": "781-674-1189",
"fax_number": "781-863-2646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 BEDFORD ST",
"address_2": "SUITE 20",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024204319",
"telephone_number": "781-674-1189",
"fax_number": "781-863-2646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARL",
"first_name": "ELIZABETH",
"credential": "RD LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "1024",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0000ICM134",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.