Individual provider Active NPI

Matthew J Landry, PHD, RDN

  • Registered Dietitian
  • Redwood City, CA
National Provider Identifier
1598336687
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3205 Issued in LA
Practice address
101 Maple St Apt 4303
Redwood City, CA 94063-1974
Phone
(985) 519-4029
NPI assigned
Jul 8, 2021
Last updated
Jul 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 3205 LA Primary

Addresses

Primary practice location

101 Maple St Apt 4303
Redwood City, CA 94063-1974

Mailing address

101 Maple St Apt 4303
Redwood City, CA 94063-1974
Phone (985) 519-4029

Other practice location 1

103 Family St
Pierre Part, LA 70339-4216
Phone (985) 519-4029

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1598336687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAPLE ST APT 4303",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631974",
            "telephone_number": "985-519-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAPLE ST APT 4303",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631974",
            "telephone_number": "985-519-4029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Family St",
            "address_purpose": "LOCATION",
            "city": "Pierre Part",
            "state": "LA",
            "postal_code": "703394216",
            "country_code": "US",
            "telephone_number": "985-519-4029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "LA",
            "license": "3205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.