Active NPI
Victoria Bongiorno, MS, RD, CPT
- Registered Dietitian
- Palm Coast, FL
National Provider Identifier
1912743774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86357532
- Practice address
- 463 Grand Landings Pkwy
Palm Coast, FL 32164-2346 - Phone
- (406) 880-5243
- NPI assigned
- Jul 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 86357532 | FL | Primary |
Addresses
Primary practice location
463 Grand Landings Pkwy
Palm Coast, FL 32164-2346
Mailing address
PO Box 2474
Flagler Beach, FL 32136
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 |
|---|---|---|---|
| 86357532 | FL | MD | 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": "1719878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1912743774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2474",
"city": "FLAGLER BEACH",
"state": "FL",
"postal_code": "32136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "463 GRAND LANDINGS PKWY",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321642346",
"telephone_number": "406-880-5243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONGIORNO",
"first_name": "VICTORIA",
"credential": "MS, RD, CPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-02",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "86357532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.