Individual provider Active NPI

Nicole Marie Cruz Rivera I, LND

  • Registered Dietitian
  • Cidra, PR
National Provider Identifier
1144967928
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2089 Issued in PR
Practice address
Carretera 172 KM 13.7 Interior Calle Barcelo
Cidra, PR 00739
Phone
(787) 678-8546
NPI assigned
May 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2022

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 2089 PR Primary

Addresses

Primary practice location

Carretera 172 KM 13.7 Interior Calle Barcelo
Cidra, PR 00739

Mailing address

Vistas de Sabanera
Calle Tanama 501
Cidra, PR 00739
Phone (787) 678-8546

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

State licenses

LicenseStateTypeSpecialty
2089PRMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1144967928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VISTAS DE SABANERA",
            "address_2": "CALLE TANAMA 501",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "00739",
            "telephone_number": "787-678-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 172 KM 13.7 INTERIOR CALLE BARCELO",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "00739",
            "telephone_number": "787-678-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ RIVERA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_suffix": "I",
        "credential": "LND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PR",
            "license": "2089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cidra, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.