Individual provider Active NPI

Christianna A Moran, RD

  • Registered Dietitian
  • Wayland, MA
National Provider Identifier
1407125537
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2694 Issued in MA
Practice address
185 Commonwealth Rd
Wayland, MA 01778-5055
Phone
(508) 561-5920
NPI assigned
Dec 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2694 MA Primary

Addresses

Primary practice location

185 Commonwealth Rd
Wayland, MA 01778-5055

Mailing address

185 Commonwealth Rd
Wayland, MA 01778-5055
Phone (508) 561-5920

Other practice location 1

630 Plantation St
Worcester, MA 01605-2038
Phone (508) 852-6175

Other practice location 2

20 Wall St
Burlington, MA 01803-4758
Phone (781) 221-2500

Other names 1

  • Christianna A Woodcock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141211001486 MA Practitioner - Registered Dietitian Or Nutrition Professional 4385966845 Reassigns benefits to 1 organization
Practice locations: Wayland, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2694MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Boston Gastroenterology CurrentSince Jul 1, 2016 Accepting new patients
Cultivate Nutrition Consulting Dietitian, Registered PastSince Apr 29, 2018 Accepting new patients

Locations

475 Franklin St
Ste 110
Framingham, MA 01702
Phone (508) 620-9200

Organizations & group practices 2

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": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1407125537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 COMMONWEALTH RD",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017785055",
            "telephone_number": "508-561-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 COMMONWEALTH RD",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017785055",
            "telephone_number": "508-561-5920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 Plantation St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052038",
            "country_code": "US",
            "telephone_number": "508-852-6175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Wall St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018034758",
            "country_code": "US",
            "telephone_number": "781-221-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "CHRISTIANNA",
        "middle_name": "A",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTIANNA",
            "last_name": "WOODCOCK",
            "middle_name": "A",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wayland, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.