Individual provider Active NPI

Jolene O'Brien, MS RD LDN

  • Registered Dietitian
  • Lakeville, MA
National Provider Identifier
1790547461
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LDN5439 Issued in MA
Practice address
10 Main St
Lakeville, MA 02347-1674
Phone
(508) 923-1103
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 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 LDN5439 MA Primary

Addresses

Primary practice location

10 Main St
Lakeville, MA 02347-1674

Mailing address

41 Olive St
Newburyport, MA 01950-2313
Phone (508) 335-9386

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250311000921 MA Practitioner - Registered Dietitian Or Nutrition Professional 8921529603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nutrition for Life IncGroup PAC ID 2668533282, 2 clinicians

Practice addresses (Care Compare)

10 Main St
Lakeville, MA 02347-1674
Phone (508) 923-1103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LDN5439MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition for Life, Inc. Dietitian, Registered CurrentSince Feb 1, 2025 Accepting new patients

Locations

10 Main St
Lakeville, MA 02347
Phone (508) 361-3607

Organizations & group practices 1

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1790547461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 OLIVE ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502313",
            "telephone_number": "508-335-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MAIN ST",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023471674",
            "telephone_number": "508-923-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JOLENE",
        "credential": "MS RD LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "LDN5439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.