Active NPI
Anuradha Raghupathi Manthripragada, MS, RD, LDN, CNSC
- Pediatric Nutrition Registered Dietitian
- Los Angeles, CA
National Provider Identifier
1891010575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 813060
- Practice address
- 2051 Marengo St
Room 1H212
Los Angeles, CA 90033-1352 - Phone
- (323) 409-6979
- NPI assigned
- Apr 6, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L001281 | NC | |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 813060 | IL | Primary |
Addresses
Primary practice location
2051 Marengo St
Room 1H212
Los Angeles, CA 90033-1352
Mailing address
2051 Marengo St
Room 1H 212
Los Angeles, CA 90033-1352
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891010575 | Other | NC | NPI # |
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L001281 | NC | MD | Registered Dietitian |
| 813060 | IL | MD | Pediatric Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1891010575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2051 MARENGO ST",
"address_2": "ROOM 1H 212",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 MARENGO ST",
"address_2": "ROOM 1H212",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331352",
"telephone_number": "323-409-6979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANTHRIPRAGADA",
"first_name": "ANURADHA",
"middle_name": "RAGHUPATHI",
"name_prefix": "Mrs.",
"credential": "MS, RD, LDN, CNSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-06",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L001281",
"primary": false
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "IL",
"license": "813060",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI #",
"identifier": "1891010575",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.