Active NPI
Bethany L. Gentile
- Registered Dietitian
- Brighton, MA
National Provider Identifier
1962770313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1039178
- Practice address
- 736 Cambridge St
Brighton, MA 02135-2907 - Phone
- (617) 789-5115
- NPI assigned
- Dec 13, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 1039178 | MA | Primary |
Addresses
Primary practice location
736 Cambridge St
Brighton, MA 02135-2907
Mailing address
736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-5115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1039178 | Other | MA | MA LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1039178 | MA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | 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": "1323734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1962770313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "736 CAMBRIDGE ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352907",
"telephone_number": "617-789-5115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 CAMBRIDGE ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352907",
"telephone_number": "617-789-5115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTILE",
"first_name": "BETHANY",
"middle_name": "L.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-13",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "1039178",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA LICENSE",
"identifier": "1039178",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.