Individual provider Active NPI

Krista Hollinshead Fogarty, RD

  • Registered Dietitian
  • New London, CT
National Provider Identifier
1649565334
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000652 Issued in CT
Practice address
365 Montauk Ave
Lawrence and Memorial Hospital Food and Nutrition Dept
New London, CT 06320-4700
Phone
(860) 442-0711
NPI assigned
Jun 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000652 CT Primary

Addresses

Primary practice location

365 Montauk Ave
Lawrence and Memorial Hospital Food and Nutrition Dept
New London, CT 06320-4700

Mailing address

365 Montauk Avenue
Lawrence and Memorial Hospital Food and Nutrition Dept
New London, CT 06320-4769
Phone (860) 442-0711

Other names 1

  • Krista Wells Hollinshead Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110630000019 CT Practitioner - Registered Dietitian Or Nutrition Professional 2961680533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000652CTMDAddiction (Substance Use Disorder) Counselor
652CTMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital Current Accepting new patients
Hartford Hospital CurrentSince May 18, 2011 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1649565334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVENUE",
            "address_2": "LAWRENCE AND MEMORIAL HOSPITAL FOOD AND NUTRITION DEPT",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204769",
            "telephone_number": "860-442-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "address_2": "LAWRENCE AND MEMORIAL HOSPITAL FOOD AND NUTRITION DEPT",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "KRISTA",
        "middle_name": "HOLLINSHEAD",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "000652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "HOLLINSHEAD",
            "middle_name": "WELLS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.