Active NPI
Joanne C Mailloux, MS, RD, LD
- Registered Dietitian
- Gardner, MA
National Provider Identifier
1871625715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1966
- Practice address
- 242 Green St
Gardner, MA 01440-1336 - Phone
- (978) 630-6234
- Fax
- (978) 630-6820
- NPI assigned
- Mar 9, 2007
- Last updated
- Aug 13, 2010
- 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 | 1966 | MA | Primary |
Addresses
Primary practice location
242 Green St
Gardner, MA 01440-1336
Mailing address
242 Green St
Gardner, MA 01440-1336
Phone (978) 630-6234
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1966 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281657600000",
"number": "1871625715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 GREEN ST",
"city": "GARDNER",
"state": "MA",
"postal_code": "014401336",
"telephone_number": "978-630-6234",
"fax_number": "978-630-6820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 GREEN ST",
"city": "GARDNER",
"state": "MA",
"postal_code": "014401336",
"telephone_number": "978-630-6234",
"fax_number": "978-630-6820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAILLOUX",
"first_name": "JOANNE",
"middle_name": "C",
"credential": "MS, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2010-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "1966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardner, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.