Individual provider Active NPI

Nathanael Medunick

  • Registered Dietitian
  • Cumberland, RI
National Provider Identifier
1760344527
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LDN01311 Issued in RI
Practice address
47 Louise Luther Dr
Cumberland, RI 02864-6013
Phone
(910) 712-6206
NPI assigned
Dec 1, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X LDN01311 RI Primary

Addresses

Primary practice location

47 Louise Luther Dr
Cumberland, RI 02864-6013

Mailing address

47 Louise Luther Dr
Cumberland, RI 02864-6013
Phone (910) 712-6206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260128001593 RI Practitioner - Registered Dietitian Or Nutrition Professional 2466930896

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

317 6TH Ave
Suite 400
Des Moines, IA 50309-4037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LDN01311RIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners PC Dietitian, Registered CurrentSince Dec 14, 2025 Accepting new patients
Openloop Healthcare Partners California PC Dietitian, Registered Past Accepting new patients
Openloop Healthcare Partners New Jersey PC Dietitian, Registered Past Accepting new patients

Locations

3707 E Southern Ave
#1
Mesa, AZ 85206
Phone (424) 387-6806

3707 E Southern Ave
Mesa, AZ 85206
Phone (480) 327-9103

72650 Fred Waring Dr
Ste 106
Palm Desert, CA 92260
Phone (760) 230-9990

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

3200 Greenfield Rd
Ste 300
Dearborn, MI 48120
Phone (313) 318-8208

101 Hudson St
Jersey City, NJ 07302
Phone (516) 432-3800

450 Veterans Memorial Pkwy
Ste 7A
East Providence, RI 02914
Phone (401) 741-0127

10 Dorrance St
Ste 700
Providence, RI 02903
Phone (401) 200-8242

11815 Fountain Way
Ste 300
Newport News, VA 23606
Phone (757) 505-7574

Organizations & group practices 3

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": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1760344527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 LOUISE LUTHER DR",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028646013",
            "telephone_number": "910-712-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 LOUISE LUTHER DR",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028646013",
            "telephone_number": "910-712-6206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDUNICK",
        "first_name": "NATHANAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "RI",
            "license": "LDN01311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.