Active NPI
Brenda Baillargeon, R.D., L.D.N.
- Registered Dietitian
- Mendon, MA
National Provider Identifier
1588801799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 378
- Practice address
- 31 Hastings St
Mendon, MA 01756-1090 - Phone
- (508) 883-7322
- NPI assigned
- Jan 9, 2009
- Last updated
- Jan 9, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 378 | MA | Primary |
Addresses
Primary practice location
31 Hastings St
Mendon, MA 01756-1090
Mailing address
PO Box 506
31 Hastings St.
Mendon, MA 01756-0506
Phone (508) 883-7322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MT0225 | Other | MA | MEDICARE, PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060328000003 | MA | Practitioner - Registered Dietitian Or Nutrition Professional | 5395753727 | Practice locations: Mendon, MA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 378 | MA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brenda J. Baillargeon, Rd, LDN | Dietitian, Registered | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Positive Nutrition
- Registered Dietitian
- Mendon, MA
- NPI 1982735403
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231459200000",
"number": "1588801799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 506",
"address_2": "31 HASTINGS ST.",
"city": "MENDON",
"state": "MA",
"postal_code": "017560506",
"telephone_number": "508-883-7322",
"fax_number": "508-883-7322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 HASTINGS ST",
"city": "MENDON",
"state": "MA",
"postal_code": "017561090",
"telephone_number": "508-883-7322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILLARGEON",
"first_name": "BRENDA",
"credential": "R.D., L.D.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-09",
"last_updated": "2009-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "378",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE, PTAN",
"identifier": "MT0225",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mendon, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.