Active NPI
Jennifer Braun, RD
- Obesity and Weight Management Nutrition Registered Dietitian
- Bloomfield, CT
National Provider Identifier
1962969873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity and Weight Management Nutrition Registered Dietitian
- License
- 86071279
- Practice address
- 40 Woodland Ave
Bloomfield, CT 06002-1812 - Phone
- (860) 506-6212
- NPI assigned
- Feb 27, 2019
- 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 |
|---|---|---|---|---|
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | 86071279 | CT | Primary |
Addresses
Primary practice location
40 Woodland Ave
Bloomfield, CT 06002-1812
Mailing address
40 Woodland Ave
Bloomfield, CT 06002-1812
Phone (860) 810-9439
Other practice location 1
340 N Main St
West Hartford, CT 06117-2675
Phone (860) 263-8472
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 |
|---|---|---|---|
| 86071279 | CT | MD | Obesity and Weight Management Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourished Life, LLC | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1551225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1962969873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 WOODLAND AVE",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060021812",
"telephone_number": "860-810-9439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 WOODLAND AVE",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060021812",
"telephone_number": "860-506-6212"
}
],
"practiceLocations": [
{
"address_1": "340 N Main St",
"address_purpose": "LOCATION",
"city": "West Hartford",
"state": "CT",
"postal_code": "061172675",
"country_code": "US",
"telephone_number": "860-263-8472",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRAUN",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-27",
"last_updated": "2021-08-23",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": "CT",
"license": "86071279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.