Individual provider Active NPI

Roseanna Anderson, RD LDN

  • Nutritionist
  • Wyncote, PA
National Provider Identifier
1639209406
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
DN000282 Issued in PA
Practice address
25 Washington Lane
Suite 6A2
Wyncote, PA 19095
Phone
(215) 517-7777
Fax
(215) 517-8180
NPI assigned
Mar 7, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X DN000282 PA Primary
Registered Dietitian 133V00000X DN000282 PA

Addresses

Primary practice location

25 Washington Lane
Suite 6A2
Wyncote, PA 19095

Mailing address

447 Plymouth Road
Glenside, PA 19038-2803
Phone (215) 718-6599

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

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1639209406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 PLYMOUTH ROAD",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190382803",
            "telephone_number": "215-718-6599",
            "fax_number": "215-517-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WASHINGTON LANE",
            "address_2": "SUITE 6A2",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "19095",
            "telephone_number": "215-517-7777",
            "fax_number": "215-517-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROSEANNA",
        "credential": "RD LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PA",
            "license": "DN000282",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN000282",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyncote, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.