Active NPI
Danielle Marie Johnson, MS, RDN, CDN, CPT
- Registered Dietitian
- Coram, NY
National Provider Identifier
1447013776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86092357
- Practice address
- 114 Avalon Pines Dr
Coram, NY 11727-5126 - Phone
- (347) 730-8370
- NPI assigned
- Jan 31, 2024
- 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 | 86092357 | NY | Primary |
Addresses
Primary practice location
114 Avalon Pines Dr
Coram, NY 11727-5126
Mailing address
114 Avalon Pines Dr
Coram, NY 11727-5126
Phone (347) 730-8370
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86092357 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morning Bird 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": "1706659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706659200000",
"number": "1447013776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 AVALON PINES DR",
"city": "CORAM",
"state": "NY",
"postal_code": "117275126",
"telephone_number": "347-730-8370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 AVALON PINES DR",
"city": "CORAM",
"state": "NY",
"postal_code": "117275126",
"telephone_number": "347-730-8370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DANIELLE",
"middle_name": "MARIE",
"credential": "MS, RDN, CDN, CPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-31",
"last_updated": "2024-01-31",
"certification_date": "2024-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86092357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coram, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.