Colleen Obrien, RDN, CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

009054 Issued in NY

Practice address

322 Lake Ave
Rochester, NY 14608-1162

Phone

(585) 254-6480

Fax

(585) 254-1092

NPI assigned

Jan 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Loma Linda University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anthony L. Jordan Health CorporationGroup PAC ID 8729079785, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Anthony L. Jordan Health Corporation

  dba Jordan at CCIA

  • Federally Qualified Health Center (FQHC)
  • Canandaigua, NY
  • NPI 1649529678
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1487162533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081162",
            "telephone_number": "585-254-6480",
            "fax_number": "585-254-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081162",
            "telephone_number": "585-254-6480",
            "fax_number": "585-254-1092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Genesee St",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146113634",
            "country_code": "US",
            "telephone_number": "585-436-3040",
            "fax_number": "585-328-3812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "COLLEEN",
        "credential": "RDN, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thecla Ihuaku Obi, NP
• Peter Obourn, DO
• Sanita Obradovic, PHARM.D.
• Michael Obrecht, D.O.
• Nicole Danielle Obrecht, PA
• Eileen Obrien
• Maeghan Clare Obrien, DO
• Tara Obrien, LCSW
• Debra Lynn Obrosky, LPN
• Observation Associates of the University of Rochester

• Registered Dietitian in Rochester, NY
• Providers in Rochester, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.