Active NPI
Joan Nicole Endyke, MS, RD
- Registered Dietitian
- Milton, MA
National Provider Identifier
1801811583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1003
- Practice address
- 364 Granite Ave
Milton, MA 02186-5025 - Phone
- (617) 698-0260
- NPI assigned
- Jul 13, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1003 | MA | Primary |
Addresses
Primary practice location
364 Granite Ave
Milton, MA 02186-5025
Mailing address
162 South St
Hingham, MA 02043-4616
Phone (781) 749-9042
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1003 | MA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PJM 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, 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": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801811583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 SOUTH ST",
"city": "HINGHAM",
"state": "MA",
"postal_code": "020434616",
"telephone_number": "781-749-9042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "364 GRANITE AVE",
"city": "MILTON",
"state": "MA",
"postal_code": "021865025",
"telephone_number": "617-698-0260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENDYKE",
"first_name": "JOAN",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "MS, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "1003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milton, MA
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.