Audrey Castell Watts, RD

Individual provider Active NPI Registered Dietitian · Orange, CT

NPI 1861995599 · NPPES record last updated Jun 9, 2020

Key facts

NPI
1861995599
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86037307
Practice address
500 Boston Post Rd
Orange, CT 06477-3530
Phone
(203) 598-2606
Fax
(888) 855-7803
NPI assigned
Mar 8, 2018
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 Boston Post Rd
Orange, CT 06477-3530
Phone (203) 671-3392

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200915000661 CT Practitioner - Registered Dietitian Or Nutrition Professional 3971921594 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
001630CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Krystock LLC Dietitian, Registered Current
since Aug 15, 2020
Accepting new patients
Clifford W. Beers Guidance Clinic Inc Past Accepting new patients

Locations

500 Boston Post Rd
Orange, CT 06477
Phone (203) 671-3392

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86037307 Yes

Addresses

Primary practice location

500 Boston Post Rd
Orange, CT 06477-3530

Mailing address

58 Park Terrace Ave
West Haven, CT 06516-5233
Phone (203) 598-2606

Other practice location 1

41 Marne St
Hamden, CT 06514
Phone (203) 772-1270

Other names

  • Audrey Castell-Watts Professional name

Other providers in Orange, CT

All providers in Orange, CT · Registered Dietitian in Connecticut

Sources for this page

Verify at the official NPI Registry.