Active NPI
Kyra Tywanick, RDN
- Registered Dietitian
- Clifton, NJ
National Provider Identifier
1871341263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86210089
- Practice address
- 155 Hazel St
Clifton, NJ 07011-3423 - Phone
- (973) 772-3700
- NPI assigned
- May 9, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86210089 | NJ | Primary |
Addresses
Primary practice location
155 Hazel St
Clifton, NJ 07011-3423
Mailing address
21 Fieldstone Dr
Clinton, NJ 08809-1390
Phone (908) 894-4561
Other practice location 1
254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition With Kyra Tywanick RDN | Dietitian, Registered | Current | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Registered Dietitian
- Clinton, NJ
- NPI 1649017542
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1871341263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 FIELDSTONE DR",
"city": "CLINTON",
"state": "NJ",
"postal_code": "088091390",
"telephone_number": "908-894-4561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 HAZEL ST",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070113423",
"telephone_number": "973-772-3700"
}
],
"practiceLocations": [
{
"address_1": "254 Easton Ave",
"address_purpose": "LOCATION",
"city": "New Brunswick",
"state": "NJ",
"postal_code": "089011766",
"country_code": "US",
"telephone_number": "732-745-8600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TYWANICK",
"first_name": "KYRA",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-09",
"last_updated": "2024-05-09",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NJ",
"license": "86210089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.