Individual provider Active NPI

Mildred E Litsche

  • Registered Dietitian
  • Penn Yan, NY
National Provider Identifier
1902922776
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
0024761 Issued in NY
Practice address
316 Elm St
Penn Yan, NY 14527-1410
Phone
(315) 536-6241
Fax
(315) 536-8773
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 0024761 NY Primary

Addresses

Primary practice location

316 Elm St
Penn Yan, NY 14527-1410

Mailing address

4516 State Route 64
Canandaigua, NY 14424-9309
Phone (585) 229-2016

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

State licenses

LicenseStateTypeSpecialty
0024761NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Finger Lakes Ddso Yates Past Accepting new patients
State of New York Comptrollers Office Past Accepting new patients

Organizations & group practices 2

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902922776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 STATE ROUTE 64",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144249309",
            "telephone_number": "585-229-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 ELM ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271410",
            "telephone_number": "315-536-6241",
            "fax_number": "315-536-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITSCHE",
        "first_name": "MILDRED",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "0024761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Yan, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.