Active NPI
Rachael Mitchum, RD, LD
- Registered Dietitian
- Somerville, MA
National Provider Identifier
1861297061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 7320
- Practice address
- 643 Broadway
Somerville, MA 02145-2528 - Phone
- (617) 616-3600
- Fax
- (617) 616-3699
- NPI assigned
- Feb 13, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1629 | SC | |
| Registered Dietitian | 133V00000X | 7320 | MA | Primary |
Addresses
Primary practice location
643 Broadway
Somerville, MA 02145-2528
Mailing address
22 Pearl St Apt 1
Somerville, MA 02145-3413
Phone (803) 446-5186
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7320 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739404800000",
"number": "1861297061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 PEARL ST APT 1",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021453413",
"telephone_number": "803-446-5186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "643 BROADWAY",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021452528",
"telephone_number": "617-616-3600",
"fax_number": "617-616-3699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHUM",
"first_name": "RACHAEL",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-13",
"last_updated": "2025-02-13",
"certification_date": "2025-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "1629",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "7320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.