Active NPI
Alexandra Davanzo, MS, RD, LDN
- Registered Dietitian
- Philadelphia, PA
National Provider Identifier
1457784894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN005515
- Practice address
- 1500 Walnut St Ste 700N
Philadelphia, PA 19102-3504 - Phone
- (347) 474-9019
- NPI assigned
- Aug 20, 2013
- 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 | DN005515 | PA | Primary |
Addresses
Primary practice location
1500 Walnut St Ste 700N
Philadelphia, PA 19102-3504
Mailing address
1500 Walnut St Ste 700N
Philadelphia, PA 19102-3504
Phone (347) 474-9019
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 |
|---|---|---|---|
| DN005515 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Renfrew Centers, Inc. | Past | Accepting new patients | |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
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.
-
- Adult Mental Health Clinic/Center
- Philadelphia, PA
- NPI 1417971904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599264000000",
"number": "1457784894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 WALNUT ST STE 700N",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191023504",
"telephone_number": "347-474-9019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 WALNUT ST STE 700N",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191023504",
"telephone_number": "347-474-9019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVANZO",
"first_name": "ALEXANDRA",
"credential": "MS, RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-20",
"last_updated": "2020-09-05",
"certification_date": "2020-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN005515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.