Active NPI
Brennan Bissonnette, RDN
- Registered Dietitian
- Baltimore, MD
National Provider Identifier
1598509101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DX6712
- Practice address
- 1104 Hull St
Baltimore, MD 21230-5237 - Phone
- (443) 880-0843
- NPI assigned
- Jun 20, 2024
- Sex
- Female
- Sole proprietor
- No
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 | DX6712 | MD | Primary |
Addresses
Primary practice location
1104 Hull St
Baltimore, MD 21230-5237
Mailing address
236 S Boulevard
Nyack, NY 10960-4115
Phone (401) 787-5924
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DX6712 | MD | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1598509101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "236 S BOULEVARD",
"city": "NYACK",
"state": "NY",
"postal_code": "109604115",
"telephone_number": "401-787-5924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 HULL ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212305237",
"telephone_number": "443-880-0843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISSONNETTE",
"first_name": "BRENNAN",
"name_prefix": "Miss",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-20",
"last_updated": "2024-06-20",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "DX6712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.