Individual provider Active NPI

Meg Elizabeth McGonagle

  • Registered Dietitian
  • Great Barrington, MA
National Provider Identifier
1700539277
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86243058 Issued in MA
Practice address
20 Lewis Ave
Great Barrington, MA 01230-1827
Phone
(413) 528-8600
NPI assigned
Feb 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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 86243058 MA Primary

Addresses

Primary practice location

20 Lewis Ave
Great Barrington, MA 01230-1827

Mailing address

20 Lewis Ave
Great Barrington, MA 01230-1827
Phone (413) 528-8600

Other names 1

  • Meg Elizabeth Boyer Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919001595 MA Practitioner - Registered Dietitian Or Nutrition Professional 2062890585 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5553MAMDMental Health Counselor
86243058MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Medical Center, Inc CurrentSince May 31, 2022 Accepting new patients
Berkshire Medical Center Inc. CurrentSince May 31, 2022 Accepting new patients

Locations

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

Organizations & group practices 4

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": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1700539277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LEWIS AVE",
            "city": "GREAT BARRINGTON",
            "state": "MA",
            "postal_code": "012301827",
            "telephone_number": "413-528-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 LEWIS AVE",
            "city": "GREAT BARRINGTON",
            "state": "MA",
            "postal_code": "012301827",
            "telephone_number": "413-528-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGONAGLE",
        "first_name": "MEG",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "86243058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEG",
            "last_name": "BOYER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Great Barrington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.