Active NPI
Matthew Poland, RD, LDN
- Registered Dietitian
- Frederick, MD
National Provider Identifier
1912643461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86109473
- Practice address
- 6012 Jefferson Blvd
Frederick, MD 21703-6953 - Phone
- (301) 371-7160
- NPI assigned
- May 9, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X | |||
| Registered Dietitian | 133V00000X | 86109473 | MD | Primary |
Addresses
Primary practice location
6012 Jefferson Blvd
Frederick, MD 21703-6953
Mailing address
1500 Riverwalk PL Unit 221
Frederick, MD 21701-2707
Phone (240) 751-3892
Other practice location 1
810 Toll House Ave
Frederick, MD 21701-4519
Phone (301) 580-0008
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mpoland@kindrednutrition.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86109473 | MD | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652054400000",
"number": "1912643461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 RIVERWALK PL UNIT 221",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217012707",
"telephone_number": "240-751-3892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6012 JEFFERSON BLVD",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217036953",
"telephone_number": "301-371-7160"
}
],
"practiceLocations": [
{
"address_1": "810 Toll House Ave",
"address_purpose": "LOCATION",
"city": "Frederick",
"state": "MD",
"postal_code": "217014519",
"country_code": "US",
"telephone_number": "301-580-0008",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLAND",
"first_name": "MATTHEW",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-09",
"last_updated": "2022-05-09",
"certification_date": "2022-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1501X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MD",
"license": "86109473",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mpoland@kindrednutrition.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "810 Toll House Ave",
"city": "Frederick",
"state": "MD",
"country_code": "US",
"postal_code": "217014519",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.