Johanna Davenport, RDN
NPI 1063284917ActiveIndividual· Dietitian, Registered· Manchester, CT
Dietitian, Registered (RDN) in Manchester, Connecticut, licensed in CT, with an NPI issued in October 2023. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1063284917 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RDN |
| Sole proprietor | Yes |
| NPI issued | Oct 24, 2023 |
| Last updated in NPPES | Oct 13, 2026 |
| Certified by provider | Oct 13, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 002335 | CT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (TX) |
|---|
Other Dietitian, Registered providers in Manchester
- 1679984488
- 1720967094
- 1598633745
- 1306278411
- 1316132152
- 1720480965
- 1376958926
- 1760167134
- 1467635714
- 1285821793
- 1851522650
- 1063140515