Individual provider Active NPI

Gina Marie Rancourt, MS, RDN, CD

  • Registered Dietitian
  • South Burlington, VT
National Provider Identifier
1821342221
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3368 Issued in MA
Practice address
366 Dorset St Ste 10
South Burlington, VT 05403-4479
Phone
(802) 999-9207
NPI assigned
Nov 7, 2012
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 3368 MA Primary

Addresses

Primary practice location

366 Dorset St Ste 10
South Burlington, VT 05403-4479

Mailing address

PO Box 122
Waterbury, VT 05676-0122
Phone (508) 364-0461

Other practice location 1

27 Industrial Way
Georgetown, Grand Cayman 1102
KY
Phone (345) 324-2502

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171122000288 VT Practitioner - Registered Dietitian Or Nutrition Professional 7315204641 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3368MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Health Nutrition, PLLC Dietitian, Registered CurrentSince Oct 6, 2017 Accepting new patients
Elite Health and Wellness LLC Past Accepting new patients

Locations

302 Mountain View Dr
Ste 101
Colchester, VT 05446
Phone (802) 999-9207

366 Dorset St
Ste 10
South Burlington, VT 05403
Phone (802) 654-7607

Organizations & group practices 2

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": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821342221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056760122",
            "telephone_number": "508-364-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 DORSET ST STE 10",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034479",
            "telephone_number": "802-999-9207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Industrial Way",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "Grand Cayman",
            "postal_code": "1102",
            "country_code": "KY",
            "telephone_number": "345-324-2502",
            "country_name": "Cayman Islands",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "RANCOURT",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "MS, RDN, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "3368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.