Individual provider Active NPI

Roseann Nicholls, RD

  • Registered Dietitian
  • Brooklyn, NY
National Provider Identifier
1073309993
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86018859
Practice address
297 Lenox Rd Apt 2B
Brooklyn, NY 11226-2279
Phone
(917) 771-6875
NPI assigned
Apr 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86018859 Primary

Addresses

Primary practice location

297 Lenox Rd Apt 2B
Brooklyn, NY 11226-2279

Mailing address

297 Lenox Rd Apt 2B
Brooklyn, NY 11226-2279
Phone (917) 771-6875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1073309993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 LENOX RD APT 2B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262279",
            "telephone_number": "917-771-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 LENOX RD APT 2B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262279",
            "telephone_number": "917-771-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "ROSEANN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "86018859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.