Active NPI
Gina Marie Izbicki, R.D, L.D.N
- Registered Dietitian
- Salem, MA
National Provider Identifier
1689114183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4166
- Practice address
- 16 Front St Ste 209
Salem, MA 01970-3743 - Phone
- (978) 927-0990
- Fax
- (866) 921-9387
- NPI assigned
- Mar 2, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 4166 | MA | Primary |
Addresses
Primary practice location
16 Front St Ste 209
Salem, MA 01970-3743
Mailing address
16 Front St Ste 209
Salem, MA 01970-3743
Phone (978) 927-0990
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4166 | MA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1689114183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 FRONT ST STE 209",
"city": "SALEM",
"state": "MA",
"postal_code": "019703743",
"telephone_number": "978-927-0990",
"fax_number": "866-921-9387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 FRONT ST STE 209",
"city": "SALEM",
"state": "MA",
"postal_code": "019703743",
"telephone_number": "978-927-0990",
"fax_number": "866-921-9387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZBICKI",
"first_name": "GINA",
"middle_name": "MARIE",
"credential": "R.D, L.D.N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-02",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.