NATICK SPORTS AND RACQUET CLUB (NPI# 1972677326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972677326 |
| Entity Type | Organization |
| Organization Name | NATICK SPORTS AND RACQUET CLUB |
| Other Organization Name | LONGFELLOW SPORTS CLUB |
| Practice Address |
203 Oak St Longfellow Sports Club Natick MA 01760-1306 |
| Practice Telephone | 5086534633 |
| Practice Fax Number | 5086504986 |
| Mailing Telephone | 5086534633 |
| Mailing Fax Number | 5086504986 |
| Enumeration Date | 2006-11-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MISS JANE POLLEY (DIETITIAN) |
| Authorized Official Telephone | 5086534633 |
| Authorized Official Credential | M.S., R.D., LDN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | LDN1011 | MA | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS | 763282 | 01 |
| MA | BLUE CROSS BLUE SHIELD | LD0022 | 01 |
| MA | AETNA | 5582051 | 01 |
| MA | HARVARD PILGRIM HEALTH | 39410 | 01 |
| MA | UNITED HEALTH CARE | 6300209 | 01 |
| Other Name | Type Code |
|---|---|
| Longfellow Sports Club | Doing Business As Name - Organization |
| Street Address |
203 OAK ST LONGFELLOW SPORTS CLUB |
| City | NATICK |
| State | MA |
| Zip Code | 01760-1306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417956335 | Integrative Therapeutics, Inc | Chiropractor | 203 Oak St, Natick, MA 01760-1306 | 2005-07-21 |
| 1982237871 | Zoe Farricker | Dietitian, Registered | 203 Oak St, Natick, MA 01760-1344 | 2020-02-19 |
| 1942711379 | Gianna Roselli | Physical Therapist | 203 Oak St, Rebound Physical Therapy, Natick, MA 01760 | 2017-10-12 |
| 1336596667 | Alexandra Laniewski | Physical Therapist | 203 Oak St, Natick, MA 01760-1306 | 2016-05-17 |
| 1801296280 | Violet Keyao Chang | Physical Therapist | 203 Oak St, Natick, MA 01760-1306 | 2014-09-04 |
| 1912307398 | Margaret Elizabeth Webster | Physical Therapist | 203 Oak St, Natick, MA 01760-1306 | 2014-09-04 |
| 1285060129 | Gonzalo Corts | Dietitian, Registered | 203 Oak St, Natick, MA 01760-1306 | 2013-09-24 |
| 1497199749 | Erin S Harrison | Physical Therapist | 203 Oak St, Natick, MA 01760-1306 | 2013-04-17 |
| 1821432170 | Jeffrey Eugene Reisman | Physical Therapist | 203 Oak St, Natick, MA 01760-1306 | 2013-04-17 |
| 1285974782 | Suzanne Berry | Physical Therapist | 203 Oak St, Rebound Physical Therapy, Natick, MA 01760-1001 | 2013-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417412842 | For Eyes Optical of Pa | Optometrist | 1300-a Worcester St, Sherwood Plaza, Plaza Suite 11, Natick, MA 01760 | 2019-02-11 |
| 1366927469 | Edith Siegel Wolfson | Social Worker | 2 Stagg Drive, Natick, MA 01760 | 2018-09-25 |
| 1447772801 | Soraia L Pinto | Registered Nurse | 10 Alden Street, Natick, MA 01760 | 2017-07-07 |
| 1003336264 | Aurora Counseling Associates | Counselor | 20 Main St. Suite 202, Natick, MA 01760 | 2017-06-20 |
| 1548790140 | Sally Miner Heerde | Speech-Language Pathologist | 38 Fairway Circle, Natick, MA 01760 | 2017-06-15 |
| 1962937516 | Michaela Rice | Behavior Technician | 841 Worcester Road, 102, Natick, MA 01760 | 2017-04-20 |
| 1831545375 | Nadia Nina Sayess | Counselor | 17 Morgan Drive, Apt 105, Natick, MA 01760 | 2016-05-13 |
| 1114398468 | Ruvarashe Swiswa | Social Worker | 251 W Central St Ste 25, Natick, MA 01760 | 2015-10-13 |
| 1669897153 | Simon Medical Service | Durable Medical Equipment & Medical Supplies | 16 Tech Circle, Natick, MA 01760 | 2014-02-20 |
| 1639418965 | Cfo Retail Services, LLC | Eyewear Supplier (Equipment, not the service) | 1245 Worcester Road, Natick Mall, Natick, MA 01760 | 2013-02-06 |
| Find all providers in zip 01760 | ||||
| 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 |
|---|---|---|---|---|
| 1679008825 | Joshua Mark Kotfila | Dietitian, Registered | 42 Silver Hill Ln Apt 7, Natick, MA 01760-3738 | 2017-04-25 |
| 1386047736 | Elizabeth Ann May | Dietitian, Registered | 13 Village Rock Ln, Apt 14, Natick, MA 01760-5710 | 2014-09-30 |
| 1770827644 | Maisie Labrie Ostrye | Dietitian, Registered | 8 Westview Ave, Natick, MA 01760 | 2012-11-16 |
| 1932471604 | Jeanne Shumrak | Dietitian, Registered | 43 Burning Tree Rd, Natick, MA 01760-3237 | 2012-01-27 |
| 1598062549 | Wendy Susan Kemp | Dietitian, Registered | 46 Fairway Cir, Natick, MA 01760-2567 | 2011-02-26 |
| 1801127758 | Megna Nutrition Associates, Inc | Dietitian, Registered | 10 W Central St, 2nd Floor, Natick, MA 01760-4537 | 2010-01-15 |
| 1407186133 | Brandon Krebs | Dietitian, Registered | 203 Oak St., Longfellow Sports Club, Natick, MA 01760-0000 | 2009-12-31 |
| 1134364029 | Steven Jac Todd Jackson | Dietitian, Registered | 15 Kansas Street, Bldg 42, Usariem-mnd, Natick, MA 01760 | 2008-12-08 |
| 1225212467 | Marie Anne Washek | Dietitian, Registered | 83 Speen Street, Natick, MA 01760 | 2007-12-24 |
| 1235227356 | Trisha Brooke Stavinoha | Dietitian, Registered | Building 42, Kansas Street, Natick, MA 01760 | 2006-10-11 |
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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.