DISTINGUISHED DIETITIAN NUTRITIONIST PLLC (NPI# 1073749297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073749297 |
| Entity Type | Organization |
| Organization Name | DISTINGUISHED DIETITIAN NUTRITIONIST PLLC |
| Other Organization Name | FEED THE SOUL NUTRITION |
| Practice Address |
312 Sherman Street Watertown NY 13601 |
| Practice Telephone | 3159559998 |
| Practice Fax Number | 3157820386 |
| Mailing Telephone | 3159559998 |
| Mailing Fax Number | 3157820386 |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2016-06-07 |
| Authorized Official Name | NICOLE S BERRY-GARNSEY (PRESIDENT/CEO) |
| Authorized Official Telephone | 3159559998 |
| Authorized Official Credential | RD, CDE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 005592 | NY | Dietary & Nutritional Service Providers |
| Other Name | Type Code |
|---|---|
| Feed the Soul Nutrition | Doing Business As Name - Organization |
| Street Address |
312 SHERMAN STREET |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003448085 | Mariana Olga Serback | Dietitian, Registered | 19500 Woodside Dr, Watertown, NY 13601-4458 | 2020-02-07 |
| 1245878032 | Samantha Kay Kratovil | Dietitian, Registered | 4 19th St Ne, Watertown, SD 57201 | 2019-12-12 |
| 1265097984 | Sarah Zappone | Dietitian, Registered | 350 Claxton Ave, Watertown, CT 06795-1947 | 2019-05-08 |
| 1619452059 | Rachel M Caine | Dietitian, Registered | 83 Palfrey St, Watertown, MA 02472-4705 | 2018-10-02 |
| 1861990400 | Hannah Meier | Dietitian, Registered | 40 Fuller Rd, Watertown, MA 02472-3313 | 2018-01-29 |
| 1780112763 | Devon Haines | Dietitian, Registered | 23 Main St Fl 2, Watertown, MA 02472-4403 | 2017-06-02 |
| 1003266453 | Watertown Urban Mission | Dietitian, Registered | 247 Factory St, Watertown, NY 13601-2748 | 2016-06-16 |
| 1164812913 | Anne Godina | Dietitian, Registered | 300 Woodview Way, Unit 216, Watertown, MA 02472-4847 | 2015-02-02 |
| 1083029094 | Mount Auburn Athletic Club, Inc. | Dietitian, Registered | 57 Coolidge Ave, Watertown, MA 02472-2802 | 2014-06-27 |
| 1669883567 | Megan Wiesner | Dietitian, Registered | 3336 17th Ave Sw, Watertown, SD 57201-6005 | 2014-05-13 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.