Individual provider Active NPI

Dyeanne Colette Martin

  • Nutritionist
  • New York, NY
National Provider Identifier
1467702084
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Practice address
1901 1St Ave
New York, NY 10029-7404
Phone
(212) 423-7591
NPI assigned
Sep 11, 2012
Last updated
Sep 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X NU Primary

Addresses

Primary practice location

1901 1St Ave
New York, NY 10029-7404

Mailing address

1940 E Tremont Ave
Apt 3G
Bronx, NY 10462-5642
Phone (718) 207-7733

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

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1467702084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 E TREMONT AVE",
            "address_2": "APT 3G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104625642",
            "telephone_number": "718-207-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297404",
            "telephone_number": "212-423-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DYEANNE",
        "middle_name": "COLETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.