Individual provider Active NPI

Pavan Rekha Sharma, MS., RD., CDE

  • Metabolic Nutrition Registered Dietitian
  • Verona, NJ
National Provider Identifier
1497848493
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
860319 Issued in NJ
Practice address
271 Grove Ave
Ste a
Verona, NJ 07044-1731
Phone
(973) 239-2600
Fax
(973) 239-0482
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 860319 NJ Primary

Addresses

Primary practice location

271 Grove Ave
Ste a
Verona, NJ 07044-1731

Mailing address

9 Bakley Ter
West Orange, NJ 07052-2169
Phone (739) 715-1630

Other identifiers 4

IdentifierTypeStateIssuer
5530864OtherNJCIGNA HEALTH CARE
3724244OtherNJHMO
7964646OtherNJAETNA
P3465920OtherNJOXFORD HEALTH CARE PLAN

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
860319NJMDMetabolic Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1497848493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BAKLEY TER",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522169",
            "telephone_number": "739-715-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 GROVE AVE",
            "address_2": "STE A",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441731",
            "telephone_number": "973-239-2600",
            "fax_number": "973-239-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "PAVAN",
        "middle_name": "REKHA",
        "name_prefix": "Ms.",
        "credential": "MS., RD., CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NJ",
            "license": "860319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "5530864",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO",
            "identifier": "3724244",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7964646",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH CARE PLAN",
            "identifier": "P3465920",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.