Active NPI
Diana Marie Bruen, RD
- Registered Dietitian
- Henrico, VA
National Provider Identifier
1982265989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 979829
- Practice address
- 2304 Boulder Run CT
Henrico, VA 23238-3644 - Phone
- (510) 227-0999
- NPI assigned
- Jun 21, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 979829 | VA | Primary |
Addresses
Primary practice location
2304 Boulder Run CT
Henrico, VA 23238-3644
Mailing address
2304 Boulder Run CT
Henrico, VA 23238-3644
Phone (510) 227-0999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 979829 | Other | COMMISSION ON DIETETIC REGISTRATION |
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 |
|---|---|---|---|
| 979829 | VA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561075200000",
"number": "1982265989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2304 BOULDER RUN CT",
"city": "HENRICO",
"state": "VA",
"postal_code": "232383644",
"telephone_number": "510-227-0999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2304 BOULDER RUN CT",
"city": "HENRICO",
"state": "VA",
"postal_code": "232383644",
"telephone_number": "510-227-0999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUEN",
"first_name": "DIANA",
"middle_name": "MARIE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-21",
"last_updated": "2019-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "VA",
"license": "979829",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMISSION ON DIETETIC REGISTRATION",
"identifier": "979829",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Henrico, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.