Active NPI
Katie N. Crupi- Sullivan, R.D.
- Registered Dietitian
- Falmouth, MA
National Provider Identifier
1437232147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2363
- Practice address
- 210 Jones Rd
Suite 11
Falmouth, MA 02540-2974 - Phone
- (508) 299-8202
- Fax
- (508) 299-8355
- NPI assigned
- Oct 24, 2006
- 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 | 2363 | MA | Primary |
Addresses
Primary practice location
210 Jones Rd
Suite 11
Falmouth, MA 02540-2974
Mailing address
210 Jones Rd
Suite 11
Falmouth, MA 02540-2974
Phone (508) 299-8202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2363 | Other | MA | MASSACHUSETSS LICENSE |
Other names 1
- Katie N. Crupi
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 |
|---|---|---|---|
| 2363 | MA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emerald Physician Services, LLC | 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.
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- Hyannis, MA
- NPI 1952443244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251158400000",
"number": "1437232147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 JONES RD",
"address_2": "SUITE 11",
"city": "FALMOUTH",
"state": "MA",
"postal_code": "025402974",
"telephone_number": "508-299-8202",
"fax_number": "508-299-8355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 JONES RD",
"address_2": "SUITE 11",
"city": "FALMOUTH",
"state": "MA",
"postal_code": "025402974",
"telephone_number": "508-299-8202",
"fax_number": "508-299-8355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUPI- SULLIVAN",
"first_name": "KATIE",
"middle_name": "N.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2009-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "2363",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSACHUSETSS LICENSE",
"identifier": "2363",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATIE",
"last_name": "CRUPI",
"middle_name": "N.",
"credential": "R.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Falmouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.