Melissa A. Nicol, DIETICIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164005484 Issued in IL

Practice address

415 N 9TH St
Ste 6W100
Springfield, IL 62702-5303

Phone

(217) 545-8000

Fax

(217) 545-9217

NPI assigned

Jul 25, 2011

Last updated

Nov 15, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Melissa A Miller Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment Care Compare group NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1326326380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19640",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949640",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 9TH ST",
            "address_2": "STE 6W100",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025303",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOL",
        "first_name": "MELISSA",
        "middle_name": "A.",
        "credential": "DIETICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS LICENSE",
            "identifier": "164.005484",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MILLER",
            "middle_name": "A",
            "credential": "DIETICIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Dawn Nicholson-Schahl, MOT, OTR/L
• Nicole Nicholson, LCSW
• Sheila M. Nicholson, P.T., M.S.
• Gayla J Nickel, COTA
• Kaylyn Marie Nickelson, OD
• Sarah Nicolas
• Daniel J Niebrugge, M.D.
• Emily Nielsen, FNP
• Niemann Foods Inc (County Market Pharmacy 226)
• Niemann Foods Inc (County Market Pharmacy 227)

• Registered Dietitian in Springfield, IL
• Providers in Springfield, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.