Individual provider Active NPI

Annabelle Schifferdecker De Aguiar, RD, CD-N

  • Registered Dietitian
  • Hollywood, FL
National Provider Identifier
1982070447
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND7307 Issued in FL
Practice address
520 S Park Rd
12-23
Hollywood, FL 33021-8595
Phone
(860) 463-4482
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND7307 FL Primary

Addresses

Primary practice location

520 S Park Rd
12-23
Hollywood, FL 33021-8595

Mailing address

245 Pearl Street
Enfield, CT 06082
Phone (860) 463-4482

Other names 1

  • Annabelle Grace Schifferdecker Former name

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

State licenses

LicenseStateTypeSpecialty
ND7307FLMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1982070447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 PEARL STREET",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "06082",
            "telephone_number": "860-463-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S PARK RD",
            "address_2": "12-23",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218595",
            "telephone_number": "860-463-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE AGUIAR",
        "first_name": "ANNABELLE",
        "middle_name": "SCHIFFERDECKER",
        "name_prefix": "Mrs.",
        "credential": "RD, CD-N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND7307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNABELLE",
            "last_name": "SCHIFFERDECKER",
            "middle_name": "GRACE",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.

Verify at the official NPI Registry.