Active NPI
Nikki Kirby
- Registered Dietitian
- Surprise, AZ
National Provider Identifier
1245018845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86114715
- Practice address
- 12650 N 150TH LN
Surprise, AZ 85379-6916 - Phone
- (480) 202-8862
- NPI assigned
- Sep 15, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86114715 | AZ | Primary |
Addresses
Primary practice location
12650 N 150TH LN
Surprise, AZ 85379-6916
Mailing address
PO Box 8553
Surprise, AZ 85374-0125
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 |
|---|---|---|---|
| 86114715 | AZ | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1245018845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8553",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853740125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12650 N 150TH LN",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853796916",
"telephone_number": "480-202-8862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRBY",
"first_name": "NIKKI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-15",
"last_updated": "2024-01-22",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "86114715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.