Nicole Katherine White, RD, CSSD, LDN

Primary specialty

Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X

License

084432 Issued in IA

Practice address

100 Servais Way
RM 210
Hurlburt Field, FL 32544

Phone

(850) 884-4661

NPI assigned

Jun 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1104230192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 98 PALMS BLVD UNIT 4312",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412778",
            "telephone_number": "901-485-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SERVAIS WAY",
            "address_2": "RM 210",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "32544",
            "telephone_number": "850-884-4661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2004 98 Palms Blvd Unit 4312",
            "address_purpose": "LOCATION",
            "city": "Destin",
            "state": "FL",
            "postal_code": "325412778",
            "country_code": "US",
            "telephone_number": "901-485-4939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "NICOLE",
        "middle_name": "KATHERINE",
        "credential": "RD, CSSD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164006212",
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "IA",
            "license": "084432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eat2competerd@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2004 98 Palms Blvd Unit 4312",
            "city": "Destin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325412778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Nicole.white.ctr.14@us.af.mil",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "100 Servais Way",
            "city": "Hurlburt Field",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine M Ware, PHD
• Jeri Watson, DO
• Kathleen June Webster, IDMT
• Brian Wells
• Nicholas Todd Wentworth, IDMT
• Lawrence Allen Whitmore, IDMT
• Joseph Harold Williams III, IDMT
• Laura Williams, APRN
• Chad Eldon Willis, O.D.
• Kimberly Joy Woideck, O.D.

• Sports Dietetics Nutrition Registered Dietitian in Hurlburt Field, FL
• Providers in Hurlburt Field, FL by specialty
• Sports Dietetics Nutrition Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.