Individual provider Active NPI

Kristine Berube, RDN

  • Registered Dietitian
  • Boston, MA
National Provider Identifier
1619474392
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3872 Issued in MA
Practice address
710 E 7TH St
Boston, MA 02127
Phone
(978) 340-8834
NPI assigned
Apr 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X NU3872 MA
Registered Dietitian 133V00000X 3872 MA Primary

Addresses

Primary practice location

710 E 7TH St
Boston, MA 02127

Mailing address

710 E 7TH St
Boston, MA 02127-4349
Phone (978) 340-8834

Other practice location 1

399 Boylston Street Unit 900A
Boston, MA 02116-3305
Phone (978) 340-8834

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

LicenseStateTypeSpecialty
NU3872MAMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1619474392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 E 7TH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021274349",
            "telephone_number": "978-340-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E 7TH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02127",
            "telephone_number": "978-340-8834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 Boylston Street Unit 900A",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021163305",
            "country_code": "US",
            "telephone_number": "978-340-8834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERUBE",
        "first_name": "KRISTINE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MA",
            "license": "NU3872",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "3872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; 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.