Boston Functional Nutrition

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2715 Issued in MA

Legal business name

BOSTON FUNCTIONAL NUTRITION

Practice address

97 Lowell Rd
Millbrook Tarry
Concord, MA 01742-1733

Phone

(617) 650-7572

Fax

(888) 835-5844

NPI assigned

Jan 26, 2015

Organization subpart

No

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

Authorized official

Name

Ayla Withee, RD, LDN

Title

Owner

Phone

(617) 650-7572

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1609266931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 VIRGINIA FARME LN",
            "city": "CARLISLE",
            "state": "MA",
            "postal_code": "017411302",
            "telephone_number": "617-650-7572",
            "fax_number": "888-835-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 LOWELL RD",
            "address_2": "MILLBROOK TARRY",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421733",
            "telephone_number": "617-650-7572",
            "fax_number": "888-835-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON FUNCTIONAL NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "WITHEE",
        "authorized_official_first_name": "AYLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-650-7572",
        "authorized_official_credential": "RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Boker
• Shawn Norris Boland, R.PH.
• Sara M. Bolton, MD
• Jamie Bond, M.D.
• Dana A Booth, DMD
• Kelley Bothe, MSW, LICSW
• Anya M Botman
• Karen Louise Bougas, MD MPH
• Emily McCoy Bouley, M.D.
• Cailey Boumil

• Registered Dietitian in Concord, MA
• Providers in Concord, MA by specialty
• Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.