Active NPI
Nicole Boon Lopes, RD, LD/N
- Registered Dietitian
- West Palm Beach, FL
National Provider Identifier
1174203111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1096920
- Practice address
- 3300 Forest Hill Blvd BLDG E
West Palm Beach, FL 33406-5813 - Phone
- (561) 468-2230
- NPI assigned
- Jul 24, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 9850 | FL | |
| Registered Dietitian | 133V00000X | 1096920 | FL | Primary |
Addresses
Primary practice location
3300 Forest Hill Blvd BLDG E
West Palm Beach, FL 33406-5813
Mailing address
50 Menores Ave Apt 630
Coral Gables, FL 33134-4043
Phone (787) 944-3134
Other practice location 1
50 Menores Ave Apt 630
Coral Gables, FL 33134-4043
Phone (787) 944-3134
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1096920 | FL | MD | Registered Dietitian |
| 9850 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Interoperability endpoints
- nicole.boon.1@14940.direct.athenahealth.com
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1174203111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 MENORES AVE APT 630",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331344043",
"telephone_number": "787-944-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 FOREST HILL BLVD BLDG E",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334065813",
"telephone_number": "561-468-2230"
}
],
"practiceLocations": [
{
"address_1": "50 Menores Ave Apt 630",
"address_purpose": "LOCATION",
"city": "Coral Gables",
"state": "FL",
"postal_code": "331344043",
"country_code": "US",
"telephone_number": "787-944-3134",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOON LOPES",
"first_name": "NICOLE",
"credential": "RD, LD/N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-24",
"last_updated": "2023-07-24",
"certification_date": "2023-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "9850",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "1096920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.