Active NPI
Diana Cullum-Dugan, RD LDN
- Registered Dietitian
- Watertown, MA
National Provider Identifier
1629177266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1630
- Practice address
- 188 Orchard St
Watertown, MA 02472-1822 - Phone
- (617) 678-0607
- Fax
- (617) 393-4455
- NPI assigned
- Sep 21, 2006
- 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 | 1630 | MA | Primary |
Addresses
Primary practice location
188 Orchard St
Watertown, MA 02472-1822
Mailing address
188 Orchard St
Watertown, MA 02472-1822
Phone (617) 678-0607
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1630 | Other | MA | MA LICENSE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260748800000",
"number": "1629177266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 ORCHARD ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024721822",
"telephone_number": "617-678-0607",
"fax_number": "617-393-4455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 ORCHARD ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024721822",
"telephone_number": "617-678-0607",
"fax_number": "617-393-4455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLUM-DUGAN",
"first_name": "DIANA",
"credential": "RD LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2009-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "1630",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA LICENSE",
"identifier": "1630",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.