Valerie Nicholson, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD.7369 Issued in OH

Practice address

25550 Chargrin Blvd
Ste 200
Beachwood, OH 44122

Phone

(216) 765-0500

NPI assigned

Feb 7, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Valerie Broestl Former name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emily Program P C

  dba The Emily Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1528165065

  OH

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1043719834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 STORY RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25550 CHARGRIN BLVD",
            "address_2": "STE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-765-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "VALERIE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD.7369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "BROESTL",
            "credential": "RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Asa J Newsome
• Tina Newton, CRNA
• Chaquita Niamke, PSY.S.
• Evelyn Louise Nichols Ross, R.N
• Lois Lorraine Nicholson, MSN
• Nicole Gerami, LLC
• Kimberly S. Nielsen, AGACNP
• Sandra D Nigro Caboara
• Pamela M. Nilsson, PH.D.
• Mandy L Noda, FNP-C, MSN, RN

• Registered Dietitian in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.