Punithavathy Gopalan, MS,RD,LD,CDCES

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

32200565 Issued in IL

Practice address

10 Owls Head Dr
Nashua, NH 03063-1561

Phone

(603) 921-2011

NPI assigned

Dec 1, 2022

Last updated

Dec 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Nutritioninsight

  • Registered Dietitian
  • Nashua, NH
  • NPI 1891519674

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1871203729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 OWLS HEAD DR",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631561",
            "telephone_number": "603-921-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 OWLS HEAD DR",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631561",
            "telephone_number": "603-921-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPALAN",
        "first_name": "PUNITHAVATHY",
        "credential": "MS,RD,LD,CDCES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "1011335",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IL",
            "license": "32200565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhyannon Gonzalo, PA-C
• Lori Goodell, M.S., BCBA
• Jessica Goodwin, AS
• Kaylee Goodwin, BCBA
• Jessica Alice Goolishian
• Jacqueline F Gordon, PA-C
• Theresa Gordon, CRNA
• Natalia Gorecki, M.D.
• Logan Semih Gorgulu, PT
• John Carroll Gorman, M.D.

• Metabolic Nutrition Registered Dietitian in Nashua, NH
• Providers in Nashua, NH by specialty
• Metabolic Nutrition Registered Dietitian in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.