Individual provider Active NPI

Nkiru C Nzerem, R.D

  • Registered Dietitian
  • Elk Grove, CA
National Provider Identifier
1215257647
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1048771 Issued in CA
Practice address
2808 W Pintail Way
Elk Grove, CA 95757-8201
Phone
(916) 541-2438
NPI assigned
Jun 8, 2010
Last updated
Jun 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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 1048771 CA Primary

Addresses

Primary practice location

2808 W Pintail Way
Elk Grove, CA 95757-8201

Mailing address

2808 W Pintail Way
Elk Grove, CA 95757-8201
Phone (916) 541-2438

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
1048771CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1215257647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 W PINTAIL WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957578201",
            "telephone_number": "916-541-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 W PINTAIL WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957578201",
            "telephone_number": "916-541-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NZEREM",
        "first_name": "NKIRU",
        "middle_name": "C",
        "credential": "R.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1048771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.