Individual provider Active NPI

Kathleen Mary Bump, RDN, CDN

  • Registered Dietitian
  • Syracuse, NY
National Provider Identifier
1790221984
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
48008881 Issued in NY
Practice address
300 Halton Rd
Syracuse, NY 13224-2228
Phone
(315) 380-7545
NPI assigned
Jan 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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 48008881 NY Primary

Addresses

Primary practice location

300 Halton Rd
Syracuse, NY 13224-2228

Mailing address

300 Halton Rd
Syracuse, NY 13224-2228
Phone (315) 380-7545

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
48008881NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1790221984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HALTON RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132242228",
            "telephone_number": "315-380-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HALTON RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132242228",
            "telephone_number": "315-380-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMP",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "credential": "RDN, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "48008881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.