Kelli Nickerson, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

0383 Issued in SD

Practice address

1412 W Thompson Dr
Sioux Falls, SD 57105-5560

Phone

(605) 864-8112

NPI assigned

Oct 28, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cloud Health Medical Group of California, P.C.

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1194404327
  NPD (past)
• Cloud Health Medical Group, P.a.

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1528744935
  NPD (past)
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1326682857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 W THOMPSON DR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571055560",
            "telephone_number": "605-864-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 W THOMPSON DR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571055560",
            "telephone_number": "605-864-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "KELLI",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SD",
            "license": "0383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dcruz Nicholas, LPC
• Adam Hailes Nichols, D.P.M.
• Justin M. Nichols, DDS
• Tesia Patrice Nichols, MSW, LCSW
• Laura Nicholson, BSN RN GERO-BC
• Nicole Velgersdyk Counseling, LLC
• Razvan Nicolescu, M.D.
• Connie Niederauer, RDN
• Gregory George Niederauer, MD
• Ellen Janet Niedert-Hohm, M.S., LPC-MS, QMHP

• Registered Dietitian in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Registered Dietitian in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.