Vital Kidney Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

VITAL KIDNEY NUTRITION, LLC

Practice address

499 Whipple Rd
Tewksbury, MA 01876-2651

Phone

(978) 566-3989

NPI assigned

Sep 22, 2022

Last updated

Sep 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lindsay Ducharme, RD, CSR, LDNNPI 1184917932

Title

Dietitian

Phone

(978) 328-2850

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lindsay Lee Ducharme, RD

  • Registered Dietitian
  • Tewksbury, MA
  • NPI 1184917932
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1447973615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 WHIPPLE RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 WHIPPLE RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762651",
            "telephone_number": "978-566-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL KIDNEY NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "DUCHARME",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "978-328-2850",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, CSR, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Tewksbury, MA
• Providers in Tewksbury, MA by specialty
• Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.