Individual provider Active NPI

Julie H Lichtman, RD, RDN

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1770076416
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86099021 Issued in PA
Practice address
501 S 45TH St
Philadelphia, PA 19104
Phone
(267) 559-4157
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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 86099021 PA Primary

Addresses

Primary practice location

501 S 45TH St
Philadelphia, PA 19104

Mailing address

501 S 45TH St
Philadelphia, PA 19104-3913
Phone (267) 559-4157

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180719000169 PA Practitioner - Registered Dietitian Or Nutrition Professional 0446507644 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86099021PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc CurrentSince Nov 1, 2024 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Sweat and Glow, LLC Dietitian, Registered Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Nov 1, 2024 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

1331 E Wyoming Ave
Philadelphia, PA 19124
Phone (215) 537-7400

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1770076416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 45TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043913",
            "telephone_number": "267-559-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 45TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "267-559-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTMAN",
        "first_name": "JULIE",
        "middle_name": "H",
        "credential": "RD, RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "86099021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.