Individual provider Active NPI

Heather Gittleman, RD,

  • Registered Dietitian
  • Livingston, NJ
National Provider Identifier
1477741387
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
200 S Orange Ave
Livingston, NJ 07039-5817
Phone
(973) 322-7068
Fax
(973) 322-7528
NPI assigned
Oct 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

200 S Orange Ave
Livingston, NJ 07039-5817

Mailing address

1050 Galloping Hill Rd
Union, NJ 07083-7983
Phone (908) 206-2230

Other names 1

  • Heather Wallock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260424002881 NJ Practitioner - Registered Dietitian Or Nutrition Professional 4587131719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

379 Campus Dr
Somerset, NJ 08873-1161

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1477741387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 GALLOPING HILL RD",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837983",
            "telephone_number": "908-206-2230",
            "fax_number": "908-206-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817",
            "telephone_number": "973-322-7068",
            "fax_number": "973-322-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITTLEMAN",
        "first_name": "HEATHER",
        "credential": "RD,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WALLOCK",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.