Active NPI
Marjorie Debruyne, RD, CDE
- Registered Dietitian
- Bloomington, IN
National Provider Identifier
1760617476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37000857A
- Practice address
- 300 N Sheffield Dr
Bloomington, IN 47408-3141 - Phone
- (812) 340-4503
- NPI assigned
- May 26, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 37000857A | IN | Primary |
Addresses
Primary practice location
300 N Sheffield Dr
Bloomington, IN 47408-3141
Mailing address
300 N Sheffield Dr
Bloomington, IN 47408-3141
Phone (812) 340-4503
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 696214 | Other | ACADEMY OF NUTRITION AND DIETETICS | |
| 37000857A | Other | IN | STATE (LD) LICENSE NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37000857A | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1760617476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 N SHEFFIELD DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474083141",
"telephone_number": "812-340-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N SHEFFIELD DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474083141",
"telephone_number": "812-340-4503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBRUYNE",
"first_name": "MARJORIE",
"name_prefix": "Ms.",
"credential": "RD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-26",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37000857A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACADEMY OF NUTRITION AND DIETETICS",
"identifier": "696214",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE (LD) LICENSE NUMBER",
"identifier": "37000857A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.