Active NPI
Casey Ellyn Sardo, RD, LDN
- Registered Dietitian
- Pawtucket, RI
National Provider Identifier
1902318090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN00928
- Practice address
- 25 Humes St Apt 1
Pawtucket, RI 02860-2066 - Phone
- (201) 543-3459
- NPI assigned
- Oct 29, 2017
- 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 | LDN00928 | RI | Primary |
Addresses
Primary practice location
25 Humes St Apt 1
Pawtucket, RI 02860-2066
Mailing address
25 Humes St Apt 1
Pawtucket, RI 02860-2066
Phone (201) 543-3459
Other practice location 1
113 Washington St
Foxborough, MA 02035-1332
Phone (774) 215-5579
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181204003962 | RI | Practitioner - Registered Dietitian Or Nutrition Professional | 0244574093 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN00928 | RI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1902318090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 HUMES ST APT 1",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028602066",
"telephone_number": "201-543-3459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 HUMES ST APT 1",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028602066",
"telephone_number": "201-543-3459"
}
],
"practiceLocations": [
{
"address_1": "113 Washington St",
"address_purpose": "LOCATION",
"city": "Foxborough",
"state": "MA",
"postal_code": "020351332",
"country_code": "US",
"telephone_number": "774-215-5579",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SARDO",
"first_name": "CASEY",
"middle_name": "ELLYN",
"name_prefix": "Ms.",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-29",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "RI",
"license": "LDN00928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.