Active NPI
Joanna E Fitzmorris, RDN
- Registered Dietitian
- Flushing, NY
National Provider Identifier
1407693278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86376564
- Practice address
- 16019 Sanford Ave Apt 4A1
Flushing, NY 11358-4141 - Phone
- (845) 803-9052
- NPI assigned
- Jul 10, 2024
- Sex
- Unspecified or another gender identity
- 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 | 86376564 | NY | Primary |
Addresses
Primary practice location
16019 Sanford Ave Apt 4A1
Flushing, NY 11358-4141
Mailing address
16019 Sanford Ave Apt 4A1
Flushing, NY 11358-4141
Phone (845) 803-9052
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 |
|---|---|---|---|
| 86376564 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | 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": "1720569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1407693278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16019 SANFORD AVE APT 4A1",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113584141",
"telephone_number": "845-803-9052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16019 SANFORD AVE APT 4A1",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113584141",
"telephone_number": "845-803-9052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZMORRIS",
"first_name": "JOANNA",
"middle_name": "E",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2024-07-10",
"last_updated": "2024-07-10",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86376564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.