Individual provider Active NPI

Vanessa K Laffert, RD

  • Pediatric Nutrition Registered Dietitian
  • Worcester, MA
National Provider Identifier
1639378755
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
1148 Issued in MA
Practice address
55 Lake Ave N
Umass Memorial Medical Center Nutrition Dept
Worcester, MA 01655-0002
Phone
(508) 334-4572
Fax
(508) 856-8020
NPI assigned
Jul 18, 2007
Last updated
Jul 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X 1148 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Umass Memorial Medical Center Nutrition Dept
Worcester, MA 01655-0002

Mailing address

55 Lake Ave N
Umass Memorial Medical Center Nutrition Dept
Worcester, MA 01655-0002
Phone (508) 334-4572

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

State licenses

LicenseStateTypeSpecialty
1148MAMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1639378755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "UMASS MEMORIAL MEDICAL CENTER NUTRITION DEPT",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-4572",
            "fax_number": "508-856-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "UMASS MEMORIAL MEDICAL CENTER NUTRITION DEPT",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-4572",
            "fax_number": "508-856-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFFERT",
        "first_name": "VANESSA",
        "middle_name": "K",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "MA",
            "license": "1148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.