Individual provider Active NPI

Alice Marieanne Connelly, RD/LDN

  • Registered Dietitian
  • Englewood, FL
National Provider Identifier
1710125950
Registry record updated Jun 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND15153 Issued in FL
Practice address
1625 David PL
Englewood, FL 34223-4305
Phone
(330) 207-1066
NPI assigned
Jan 27, 2009
Last updated
Jun 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2026

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 ND15153 FL Primary

Addresses

Primary practice location

1625 David PL
Englewood, FL 34223-4305

Mailing address

1625 David PL
Englewood, FL 34223-4305
Phone (330) 207-1066

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

State licenses

LicenseStateTypeSpecialty
LD 4156OHMDRegistered Dietitian
DN003783PAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781395200000",
    "number": "1710125950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 DAVID PL",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234305",
            "telephone_number": "330-207-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 DAVID PL",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234305",
            "telephone_number": "330-207-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "ALICE",
        "middle_name": "MARIEANNE",
        "name_prefix": "Mrs.",
        "credential": "RD/LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2026-06-14",
        "certification_date": "2026-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND15153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.