Active NPI
Nicole P Bomar, RD
- Registered Dietitian
- Slater, MO
National Provider Identifier
1053920025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2020020010
- Practice address
- 515 Rich St
Slater, MO 65349-1251 - Phone
- (660) 631-3598
- NPI assigned
- Jul 27, 2020
- Last updated
- Dec 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2020020010 | MO | Primary |
Addresses
Primary practice location
515 Rich St
Slater, MO 65349-1251
Mailing address
515 Rich St
Slater, MO 65349-1251
Phone (660) 631-3598
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One Bite Nutrition Consulting | Dietitian, Registered | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Registered Dietitian
- Sunrise Beach, MO
- NPI 1396317806
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669939200000",
"number": "1053920025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 RICH ST",
"city": "SLATER",
"state": "MO",
"postal_code": "653491251",
"telephone_number": "660-631-3598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 RICH ST",
"city": "SLATER",
"state": "MO",
"postal_code": "653491251",
"telephone_number": "660-631-3598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOMAR",
"first_name": "NICOLE",
"middle_name": "P",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-27",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2020020010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slater, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.