NPIMap

Organization Active NPI

Community Diabetes and Nutrition Services, LLC

  • Registered Dietitian
  • Blakely, PA
National Provider Identifier
1609253301
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN000285 Issued in PA
Legal business name
COMMUNITY DIABETES AND NUTRITION SERVICES, LLC
Practice address
200 Main St
Suite L4
Blakely, PA 18447-1241
Phone
(570) 604-6677
Fax
(570) 307-4220
NPI assigned
May 1, 2015
Last updated
May 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rosemary Takacs, RN, BS, CDENPI 1588080782
Title
Member and Program Coordinator
Phone
(570) 604-6677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X DN000285 PA Primary

Addresses

Primary practice location

200 Main St
Suite L4
Blakely, PA 18447-1241

Mailing address

200 Main St
Suite L4
Blakely, PA 18447-1241
Phone (570) 604-6677

Other identifiers 1

IdentifierTypeStateIssuer
1306930847OtherPABLUE CROSS OF NORTHEAST PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1609253301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "address_2": "SUITE L4",
            "city": "BLAKELY",
            "state": "PA",
            "postal_code": "184471241",
            "telephone_number": "570-604-6677",
            "fax_number": "570-307-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN ST",
            "address_2": "SUITE L4",
            "city": "BLAKELY",
            "state": "PA",
            "postal_code": "184471241",
            "telephone_number": "570-604-6677",
            "fax_number": "570-307-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DIABETES AND NUTRITION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "TAKACS",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "MEMBER AND PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "570-604-6677",
        "authorized_official_credential": "RN, BS, CDE"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN000285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NORTHEAST PA",
            "identifier": "1306930847",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blakely, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.