Active NPI
Phyllis C Freedman, RD
- Nutrition Education Nutritionist
- Providence, RI
National Provider Identifier
1790894947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Education Nutritionist
- License
- LDN00117
- Practice address
- 148 W River St
Suite 2a
Providence, RI 02904-2615 - Phone
- (401) 861-2233
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | LDN00117 | RI | Primary |
Addresses
Primary practice location
148 W River St
Suite 2a
Providence, RI 02904-2615
Mailing address
148 W River St
Suite 2a
Providence, RI 02904-2615
Phone (401) 861-2233
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 |
|---|---|---|---|
| LDN00117 | RI | MD | Nutrition Education Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790894947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 W RIVER ST",
"address_2": "SUITE 2A",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029042615",
"telephone_number": "401-861-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 W RIVER ST",
"address_2": "SUITE 2A",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029042615",
"telephone_number": "401-861-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "PHYLLIS",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "RI",
"license": "LDN00117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.