Individual provider Active NPI

Carey Lynne Emmons, R.D.,L.D.N.

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1811147929
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN003802 Issued in PA
Practice address
925 Chestnut St
Fifth Floor
Philadelphia, PA 19107-4216
Phone
(267) 339-3551
Fax
(215) 503-0580
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X DN003802 PA
Registered Dietitian 133V00000X DN003802 PA Primary

Addresses

Primary practice location

925 Chestnut St
Fifth Floor
Philadelphia, PA 19107-4216

Mailing address

170 N Henderson Rd
King of Prussia, PA 19406-2155
Phone (610) 755-3710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090102000205 PA Practitioner - Registered Dietitian Or Nutrition Professional 4183786908 Reassigns benefits to 1 organization
I20090514000422 NJ Practitioner - Registered Dietitian Or Nutrition Professional 4183786908

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Simplex HealthGroup PAC ID 8022354182, 23 clinicians

Practice addresses (Care Compare)

300 Brookside Ave
Suite 125
Ambler, PA 19002-3436
Phone (877) 842-2425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN003802PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Simplex Health Dietitian, Registered CurrentSince Mar 4, 2024 Accepting new patients
Adrian Chiu, PH.D., PLLC PastSince Dec 1, 2023 Accepting new patients
Rothman Orthopaedics of New Jersey, LLC Past Accepting new patients

Locations

300 Brookside Ave
Bldg 4
Ambler, PA 19002
Phone (267) 702-4862

Organizations & group practices 3

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": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1811147929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 N HENDERSON RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062155",
            "telephone_number": "610-755-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "address_2": "FIFTH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "267-339-3551",
            "fax_number": "215-503-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMONS",
        "first_name": "CAREY",
        "middle_name": "LYNNE",
        "credential": "R.D.,L.D.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PA",
            "license": "DN003802",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN003802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.