Healthcare Provider Details

I. General information

NPI: 1285705426
Provider Name (Legal Business Name): RITA CAREY RUBIN MS, RD, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 BROAD ST STE 14281
BOSTON MA
02109-4301
US

IV. Provider business mailing address

1003 WILLOW CREEK RD
PRESCOTT AZ
86301-1641
US

V. Phone/Fax

Practice location:
  • Phone: 888-404-4813
  • Fax: 888-675-4061
Mailing address:
  • Phone: 928-771-5794
  • Fax: 928-771-5351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberNDP-2024-0078
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number225584
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number128911
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number074.0134583
License Number StateVT
# 5
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1963
License Number StateNH
# 6
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI2000
License Number StateME
# 7
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN-0011221
License Number StateDE
# 8
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number14193767-4901
License Number StateUT
# 9
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number5607
License Number StateAL
# 10
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2024030003
License Number StateMO
# 11
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3197
License Number StateSC
# 12
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number438-LD
License Number StateHI
# 13
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number011591
License Number StateNY
# 14
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.10671
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: