Active NPI
Brittany Borneman, RD, CDN
- Registered Dietitian
- Bay Shore, NY
National Provider Identifier
1720782790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86089353
- Practice address
- 16 Sugar Pine LN
Bay Shore, NY 11706-5869 - Phone
- (516) 507-0361
- NPI assigned
- Mar 27, 2023
- 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 | 86089353 | NY | Primary |
Addresses
Primary practice location
16 Sugar Pine LN
Bay Shore, NY 11706-5869
Mailing address
16 Sugar Pine LN
Bay Shore, NY 11706-5869
Phone (516) 507-0361
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86089353 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1720782790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 SUGAR PINE LN",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117065869",
"telephone_number": "516-507-0361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 SUGAR PINE LN",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117065869",
"telephone_number": "516-507-0361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORNEMAN",
"first_name": "BRITTANY",
"credential": "RD, CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2023-03-27",
"certification_date": "2023-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86089353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.