Active NPI
Vanika Jethwa, LD/RD
- Registered Dietitian
- Boston, MA
National Provider Identifier
1497215842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN4743
- Practice address
- 4 Westminster Ave Apt 1
Boston, MA 02119-1595 - Phone
- (860) 371-1907
- NPI assigned
- Mar 21, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LDN4743 | MA | Primary |
| Registered Dietitian | 133V00000X | 1009 | NH |
Addresses
Primary practice location
4 Westminster Ave Apt 1
Boston, MA 02119-1595
Mailing address
4 Westminster Ave Apt 1
Boston, MA 02119-1595
Phone (860) 371-1907
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN4743 | MA | MD | Registered Dietitian |
| 1009 | NH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1497215842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 WESTMINSTER AVE APT 1",
"city": "BOSTON",
"state": "MA",
"postal_code": "021191595",
"telephone_number": "860-371-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 WESTMINSTER AVE APT 1",
"city": "BOSTON",
"state": "MA",
"postal_code": "021191595",
"telephone_number": "860-371-1907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JETHWA",
"first_name": "VANIKA",
"credential": "LD/RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-21",
"last_updated": "2023-03-27",
"certification_date": "2023-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "LDN4743",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NH",
"license": "1009",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.