Nichole Campbell, NDTR

Primary specialty

Registered Dietetic TechnicianTaxonomy code 136A00000X

Practice address

2009 Mackenzie Way Ste 100
Cranberry Township, PA 16066-5338

Phone

(412) 501-3069

NPI assigned

Dec 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1073273199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 FALCON DR",
            "city": "VALENCIA",
            "state": "PA",
            "postal_code": "160591340",
            "telephone_number": "412-310-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 MACKENZIE WAY STE 100",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160665338",
            "telephone_number": "412-501-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "NICHOLE",
        "credential": "NDTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Irene Buonomo, LCSW
• Butler Vamc
• Jessica Lee Calhoon
• Jacob Scott Callaway, DC
• David S Campbell
• Randal L. Carbin, LMT
• Gemma Carlino, MSED, NCC, LPC, CADC
• Jessica Elizabeth Case, PSYD
• Cassandra Gengler Counseling
• Jeffrey Michael Cella Jr., PT, DPT

• Registered Dietetic Technician in Cranberry Township, PA
• Providers in Cranberry Township, PA by specialty
• Registered Dietetic Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.