Individual provider Active NPI

Charlene Ann Burian, MS RD CD IBCLC

  • Registered Dietitian
  • Fort Wayne, IN
National Provider Identifier
1730533852
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
37001225A Issued in IN
Practice address
3213 Twisted Branch PL
Fort Wayne, IN 46804-3436
Phone
(260) 436-3980
NPI assigned
Apr 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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 37001225A IN Primary

Addresses

Primary practice location

3213 Twisted Branch PL
Fort Wayne, IN 46804-3436

Mailing address

3213 Twisted Branch PL
Fort Wayne, IN 46804-3436
Phone (260) 436-3980

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
37001225AINMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1730533852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 TWISTED BRANCH PL",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468043436",
            "telephone_number": "260-436-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 TWISTED BRANCH PL",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468043436",
            "telephone_number": "260-436-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURIAN",
        "first_name": "CHARLENE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS RD CD IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37001225A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.