Kacy Romeo Disantillo

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

2000 Shore Rd Ste 104
Linwood, NJ 08221-2100

Phone

(609) 904-5627

NPI assigned

Oct 22, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vitality Nutrition and Wellness Center LLC

  • Registered Dietitian
  • Linwood, NJ
  • NPI 1720451263
  NPD

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1609475391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 SUNSET DR",
            "city": "MOUNT ROYAL",
            "state": "NJ",
            "postal_code": "080611016",
            "telephone_number": "856-534-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SHORE RD STE 104",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082212100",
            "telephone_number": "609-904-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMEO DISANTILLO",
        "first_name": "KACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Cohen Associates
• Alexander Rivera, DPT
• Erica Rivera, LCSW
• Robert Chorney PSYD at New Roads LLC
• David V Robins
• Ronald C. Gove, MD, PA
• Rosa Cortes Schwartz Mental Health Associates
• Shelley Lynne Rosenfeld, PH.D.
• Rosewood Womens Health Partners
• Amanda Rae Ross, OTR/L

• Nutritionist in Linwood, NJ
• Providers in Linwood, NJ by specialty
• Nutritionist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.