Individual provider Active NPI

Michelle Bertron, RDN

  • Registered Dietitian
  • Montour Falls, NY
National Provider Identifier
1730909573
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
931481 Issued in NY
Practice address
3835 Cronk Rd
Montour Falls, NY 14865-9710
Phone
(607) 857-6029
NPI assigned
Oct 16, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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 931481 NY Primary

Addresses

Primary practice location

3835 Cronk Rd
Montour Falls, NY 14865-9710

Mailing address

3835 Cronk Rd
Montour Falls, NY 14865-9710
Phone (607) 857-6029

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
931481NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1730909573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 CRONK RD",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659710",
            "telephone_number": "607-857-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 CRONK RD",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659710",
            "telephone_number": "607-857-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRON",
        "first_name": "MICHELLE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "931481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montour Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.