Individual provider Active NPI

Diane H. Hannon, R.D.

  • Registered Dietitian
  • Concord, MA
National Provider Identifier
1538162938
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1653 Issued in MA
Practice address
2194 Main St
Ofc 6
Concord, MA 01742-3829
Phone
(978) 505-5953
NPI assigned
May 31, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

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 1653 MA Primary

Addresses

Primary practice location

2194 Main St
Ofc 6
Concord, MA 01742-3829

Mailing address

129 Nimrod Dr
Concord, MA 01742-1646
Phone (978) 369-0035

Other identifiers 1

IdentifierTypeStateIssuer
LD0169OtherMABCBSMA LDN ANCILLARY PROV

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

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1538162938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 NIMROD DR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421646",
            "telephone_number": "978-369-0035",
            "fax_number": "978-369-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2194 MAIN ST",
            "address_2": "OFC 6",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017423829",
            "telephone_number": "978-505-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "DIANE",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "1653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA LDN ANCILLARY PROV",
            "identifier": "LD0169",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.