NPIMap

Individual provider Active NPI

Lori Fran Lieberman, RD

  • Registered Dietitian
  • Quincy, MA
National Provider Identifier
1659459956
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
743 Issued in MA
Practice address
111 Willard St Ste 2F
Quincy, MA 02169-1274
Phone
(781) 335-7559
Fax
(781) 331-6410
NPI assigned
Nov 2, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 743 MA Primary

Addresses

Primary practice location

111 Willard St Ste 2F
Quincy, MA 02169-1274

Mailing address

111 Willard St Ste 2F
Quincy, MA 02169-1274
Phone (781) 335-7559

Other practice location 1

1221 Main St
Suite 203
S Weymouth, MA 02190
Phone (781) 335-7559

Other identifiers 2

IdentifierTypeStateIssuer
714619OtherMATUFTS HEALTH
LD0143OtherMABCBS

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
743MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Foot Care Group Past 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, 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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1659459956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WILLARD ST STE 2F",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691274",
            "telephone_number": "781-335-7559",
            "fax_number": "781-331-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WILLARD ST STE 2F",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691274",
            "telephone_number": "781-335-7559",
            "fax_number": "781-331-6410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Main St",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "S Weymouth",
            "state": "MA",
            "postal_code": "02190",
            "country_code": "US",
            "telephone_number": "781-335-7559",
            "fax_number": "781-331-6410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "LORI",
        "middle_name": "FRAN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH",
            "identifier": "714619",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "LD0143",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.