NPIMap

Organization Active NPI

Susan Carroll

  • Registered Dietitian
  • West Boylston, MA
National Provider Identifier
1841052255
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SUSAN CARROLL
Practice address
360 W Boylston St
West Boylston, MA 01583-2365
Phone
(617) 398-7752
NPI assigned
Jan 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Susan CarrollNPI 1497810600
Title
Owner
Phone
(617) 398-7752

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

360 W Boylston St
West Boylston, MA 01583-2365

Mailing address

372 Meridian St
Boston, MA 02128-5123
Phone (617) 398-7752

Other names 1

  • Restore Your Health Nutrition Doing business as

National Provider Directory

National Provider Directory

Locations

360 W Boylston St
West Boylston, MA 01583
Phone (508) 847-8558

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1841052255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 MERIDIAN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021285123",
            "telephone_number": "617-398-7752",
            "fax_number": "857-264-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BOYLSTON ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832365",
            "telephone_number": "617-398-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN CARROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-398-7752"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restore Your Health Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Boylston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.