Active NPI
Kathleen R Vanhavere, MA, RD, CDE, CDN
- Registered Dietitian
- Danbury, CT
National Provider Identifier
1790759587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 000850
- Practice address
- 25 Germantown Rd
Danbury, CT 06810-5036 - Phone
- (203) 794-5637
- Fax
- (203) 794-5642
- NPI assigned
- Feb 16, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 003627 | NY | |
| Registered Dietitian | 133V00000X | 000850 | CT | Primary |
Addresses
Primary practice location
25 Germantown Rd
Danbury, CT 06810-5036
Mailing address
25 Germantown Rd
Danbury, CT 06810-5036
Phone (203) 794-5637
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133884168 | Other | NY | BEECH STREET |
| 133884168 | Other | NY | HORIZON OF NY |
| 133884168 | Other | NY | GHI PPO |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000850 | CT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nuvance Health Medical Practice CT, Inc. | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- Danbury, CT
- NPI 1407898117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289174400000",
"number": "1790759587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 GERMANTOWN RD",
"city": "DANBURY",
"state": "CT",
"postal_code": "068105036",
"telephone_number": "203-794-5637",
"fax_number": "203-794-5642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 GERMANTOWN RD",
"city": "DANBURY",
"state": "CT",
"postal_code": "068105036",
"telephone_number": "203-794-5637",
"fax_number": "203-794-5642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANHAVERE",
"first_name": "KATHLEEN",
"middle_name": "R",
"credential": "MA, RD, CDE, CDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-16",
"last_updated": "2010-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "003627",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CT",
"license": "000850",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEECH STREET",
"identifier": "133884168",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON OF NY",
"identifier": "133884168",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PPO",
"identifier": "133884168",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Danbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.