Individual provider Active NPI

Coreyann K Poly Geracie, PHD, RDN, LD, CDE

  • Metabolic Nutrition Registered Dietitian
  • Uxbridge, MA
National Provider Identifier
1881800738
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
32 Issued in MA
Practice address
60 Quaker Hwy
Uxbridge, MA 01569-1628
Phone
(508) 278-7810
NPI assigned
May 15, 2007
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 32 MA Primary

Addresses

Primary practice location

60 Quaker Hwy
Uxbridge, MA 01569-1628

Mailing address

130 Elmshade Dr
Uxbridge, MA 01569-2601
Phone (508) 278-9713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090330000253 MA Practitioner - Registered Dietitian Or Nutrition Professional 4385701721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates IncGroup PAC ID 9436118197, 3 clinicians

Practice addresses (Care Compare)

60 Quaker Hwy
Uxbridge, MA 01569-1628
Phone (508) 278-7810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
32MAMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1881800738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ELMSHADE DR",
            "city": "UXBRIDGE",
            "state": "MA",
            "postal_code": "015692601",
            "telephone_number": "508-278-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 QUAKER HWY",
            "city": "UXBRIDGE",
            "state": "MA",
            "postal_code": "015691628",
            "telephone_number": "508-278-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLY GERACIE",
        "first_name": "COREYANN",
        "middle_name": "K",
        "credential": "PHD, RDN, LD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MA",
            "license": "32",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uxbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.