Anna R Grotevant, MS, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

3557 Issued in MA

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(774) 443-3887

Fax

(774) 443-3913

NPI assigned

Jan 6, 2014

Last updated

Jul 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Anna R Polucha Former name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Umass Memorial Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Worcester, MA
  • NPI 1689760092
  Medicare reassignment NPD
• Umass Memorial Medical Center, Inc

  • Registered Dietitian
  • Worcester, MA
  • NPI 1679131361

  Dietitian, Registered

  NPD
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Marlborough, MA
  • NPI 1396738159
  NPD

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1669893996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 COBURN AVE APT 3",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041112",
            "telephone_number": "508-272-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "774-443-3887",
            "fax_number": "774-443-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTEVANT",
        "first_name": "ANNA",
        "middle_name": "R",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "3557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "POLUCHA",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia K Gross, MS, LMHC
• Mariam Ellen Grossman, PTA
• Rachel Grossman, PSYD
• Richard Alan Grossman, O.D.
• Shannon Grote, LICSW
• George Groussis, MD
• Maria Dorothea Groussis, MD
• Grove Street Chiropractic, Inc.
• Douglas Groves, M.D.
• R. John Groves, M.D.

• Registered Dietitian in Worcester, MA
• Providers in Worcester, MA by specialty
• Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.