Active NPI
Sara Donnelly, RDN
- Registered Dietitian
- Suffern, NY
National Provider Identifier
1992462311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86099730
- Practice address
- 255 Lafayette Ave
Suffern, NY 10901-4869 - Phone
- (845) 368-5000
- NPI assigned
- Nov 19, 2021
- Last updated
- Nov 19, 2021
- 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 | 86099730 | NY | Primary |
Addresses
Primary practice location
255 Lafayette Ave
Suffern, NY 10901-4869
Mailing address
47 Cooper Hill Rd
Ridgefield, CT 06877-5903
Phone (484) 889-8352
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86099730 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1992462311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 COOPER HILL RD",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068775903",
"telephone_number": "484-889-8352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 LAFAYETTE AVE",
"city": "SUFFERN",
"state": "NY",
"postal_code": "109014869",
"telephone_number": "845-368-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "SARA",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-19",
"last_updated": "2021-11-19",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86099730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffern, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.