Individual provider Active NPI

Lynn Guibbory, RD, CDN

  • Registered Dietitian
  • New Haven, CT
National Provider Identifier
1578147153
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
59.002010 Issued in CT
Practice address
330 Orchard St Ste E3300
New Haven, CT 06511-4417
Phone
(203) 680-6490
NPI assigned
May 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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 59.002010 CT Primary

Addresses

Primary practice location

330 Orchard St Ste E3300
New Haven, CT 06511-4417

Mailing address

9 Old Barn LN
Guilford, CT 06437-5025
Phone (203) 848-8699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210616002084 CT Practitioner - Registered Dietitian Or Nutrition Professional 5395145114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

330 Orchard St
New Haven, CT 06511-4417
Phone (203) 789-6047

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59.002010CTMDRegistered Dietitian
002010CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Dietitian, Registered CurrentSince Jun 21, 2021 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Jun 21, 2021 Accepting new patients

Locations

8 Devine St
North Haven, CT 06473
Phone (203) 230-3400

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Organizations & group practices 2

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": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1578147153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 OLD BARN LN",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064375025",
            "telephone_number": "203-848-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST STE E3300",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114417",
            "telephone_number": "203-680-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIBBORY",
        "first_name": "LYNN",
        "credential": "RD, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "59.002010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.