Individual provider Active NPI

Alexandra Gumen, RDN

  • Registered Dietitian
  • Summerville, SC
National Provider Identifier
1932628302
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1650 Issued in SC
Practice address
808 N Cedar St
Summerville, SC 29483-6606
Phone
(201) 566-0120
NPI assigned
Sep 16, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1650 SC Primary
Pediatric Nutrition Registered Dietitian 133VN1004X 1650 SC
Renal Nutrition Registered Dietitian 133VN1005X 1650 SC
Metabolic Nutrition Registered Dietitian 133VN1006X 1650 SC

Addresses

Primary practice location

808 N Cedar St
Summerville, SC 29483-6606

Mailing address

277 Pemberly Blvd
Summerville, SC 29486-7780
Phone (201) 566-0120

Other practice location 1

277 Pemberly Blvd
Summerville, SC 29486-7780
Phone (201) 566-0120

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1650SCMDRegistered Dietitian

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1932628302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 PEMBERLY BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867780",
            "telephone_number": "201-566-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 N CEDAR ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836606",
            "telephone_number": "201-566-0120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Pemberly Blvd",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294867780",
            "country_code": "US",
            "telephone_number": "201-566-0120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUMEN",
        "first_name": "ALEXANDRA",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "1650",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "SC",
            "license": "1650",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "SC",
            "license": "1650",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "SC",
            "license": "1650",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.