Active NPI
Kathrina Prelack
- Pediatric Nutrition Registered Dietitian
- Boston, MA
National Provider Identifier
1699324285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 1891
- Practice address
- 51 Blossom St
Boston, MA 02114-2601 - Phone
- (617) 371-4756
- NPI assigned
- Sep 6, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 1891 | MA | Primary |
Addresses
Primary practice location
51 Blossom St
Boston, MA 02114-2601
Mailing address
51 Blossom St
Boston, MA 02114-2601
Phone (617) 371-4756
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567728000000",
"number": "1699324285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 BLOSSOM ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142601",
"telephone_number": "617-371-4756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 BLOSSOM ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142601",
"telephone_number": "617-371-4756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRELACK",
"first_name": "KATHRINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-06",
"last_updated": "2019-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "MA",
"license": "1891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.