Individual provider Active NPI

Anna Titcomb

  • Registered Dietitian
  • Ellsworth, ME
National Provider Identifier
1689130494
Registry record updated Apr 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI1926 Issued in ME
Practice address
194 Main St Ste 104
Ellsworth, ME 04605-1939
Phone
(207) 813-4792
Fax
(207) 376-9825
NPI assigned
Feb 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1555 NH
Registered Dietitian 133V00000X 10251900 OR
Registered Dietitian 133V00000X 164.006493 IL
Registered Dietitian 133V00000X DI1926 ME Primary

Addresses

Primary practice location

194 Main St Ste 104
Ellsworth, ME 04605-1939

Mailing address

194 Main St Ste 104
Ellsworth, ME 04605-1939
Phone (207) 813-4792

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260414000507 ME Practitioner - Registered Dietitian Or Nutrition Professional 8729553193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 Broadway
Bucksport, ME 04416-4612

13 Maverick St
Rockland, ME 04841-3402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164.006493ILMDRegistered Dietitian
DI1926MEMDRegistered Dietitian
1555NHMDRegistered Dietitian
10251900ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Growing Wild Dietitian, Registered CurrentSince Apr 13, 2025 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": "1550361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743897600000",
    "number": "1689130494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 MAIN ST STE 104",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051939",
            "telephone_number": "207-813-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 MAIN ST STE 104",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051939",
            "telephone_number": "207-813-4792",
            "fax_number": "207-376-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITCOMB",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-17",
        "last_updated": "2025-04-06",
        "certification_date": "2025-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": "1555",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "10251900",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.006493",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI1926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.