Lisa M Gibbs, MS,RD.LDN,CSO – Registered Dietitian

Key facts

NPI: 1497923148
Entity type: Individual (NPI type 1)
Primary specialty: Registered Dietitian 133V00000X
License: 328 (MA)
Practice address: 25 Laurelwood Dr Unit 25
Hopedale, MA 01747-1983
Phone: (508) 561-3701
NPI assigned: Feb 15, 2008
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Fay Nutrition Registered Dietitian · San Francisco, CA · NPI 1104334465

NPD (past) DIETITIAN, REGISTERED

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

State licenses

License	State	Type	Specialty
328	MA	MD	Registered Dietitian

Practice roles

Organization	Specialty	Status	New patients
Fay Nutrition	Dietitian, Registered	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Registered Dietitian	133V00000X	328	MA	Yes

Addresses

Primary practice location

25 Laurelwood Dr Unit 25
Hopedale, MA 01747-1983

Mailing address

25 Laurelwood Dr Unit 25
Hopedale, MA 01747-1983
Phone (508) 561-3701

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 4, 2024.

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1497923148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LAURELWOOD DR UNIT 25",
            "city": "HOPEDALE",
            "state": "MA",
            "postal_code": "017471983",
            "telephone_number": "508-561-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LAURELWOOD DR UNIT 25",
            "city": "HOPEDALE",
            "state": "MA",
            "postal_code": "017471983",
            "telephone_number": "508-561-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MS,RD.LDN,CSO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopedale, MA

All providers in Hopedale, MA · Registered Dietitian in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.