Active NPI
Bernice Ruth Pine, R.D.
- Registered Dietitian
- Ithaca, NY
National Provider Identifier
1598085839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 305324
- Practice address
- 1 Bella Vista Drive
Ithaca, NY 14850 - Phone
- (607) 375-6330
- Fax
- (607) 375-6301
- NPI assigned
- Jun 9, 2010
- 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 | 305324 | Primary |
Addresses
Primary practice location
1 Bella Vista Drive
Ithaca, NY 14850
Mailing address
P.O. Box 383
Dryden, NY 13053
Phone (607) 753-5061
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276041600000",
"number": "1598085839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 383",
"city": "DRYDEN",
"state": "NY",
"postal_code": "13053",
"telephone_number": "607-753-5061",
"fax_number": "607-756-3478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BELLA VISTA DRIVE",
"city": "ITHACA",
"state": "NY",
"postal_code": "14850",
"telephone_number": "607-375-6330",
"fax_number": "607-375-6301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINE",
"first_name": "BERNICE",
"middle_name": "RUTH",
"name_prefix": "Miss",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-09",
"last_updated": "2010-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "305324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.