Individual provider Active NPI

Diane C. Hennessy, D.C. CDN

  • Nutritionist
  • Nanuet, NY
National Provider Identifier
1922170729
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
004088 Issued in NY
Practice address
5 Grandview Ave
Nanuet, NY 10954-2510
Phone
(845) 623-3939
Fax
(845) 624-5808
NPI assigned
Nov 15, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005349-1 NY
Nutritionist 133N00000X 004088 NY Primary

Addresses

Primary practice location

5 Grandview Ave
Nanuet, NY 10954-2510

Mailing address

5 Grandview Ave
Nanuet, NY 10954-2510
Phone (845) 623-3939

Other identifiers 3

IdentifierTypeStateIssuer
5967328OtherNYAETNA PPO
C0-5449-8OtherNYWORKERS COMPENSATION
1014308OtherNYAMERICAN SPECIALTY HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100422000394 NY Practitioner - Chiropractic 7214064252 Practice locations: Nanuet, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5 Grandview Ave
Nanuet, NY 10954-2510
Phone (845) 623-3939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005349-1NYMDChiropractor
004088NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1922170729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GRANDVIEW AVE",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542510",
            "telephone_number": "845-623-3939",
            "fax_number": "845-624-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRANDVIEW AVE",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542510",
            "telephone_number": "845-623-3939",
            "fax_number": "845-624-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "DIANE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.C.  CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-09-11",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005349-1",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "004088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5967328",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "C0-5449-8",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH",
            "identifier": "1014308",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.