Active NPI
Samantha Jane Nimmons, RD
- Registered Dietitian
- Bloomfield, CT
National Provider Identifier
1356037436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 002338
- Practice address
- 10 Jolley Dr
Bloomfield, CT 06002-3061 - Phone
- (860) 286-2470
- NPI assigned
- Apr 12, 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 | 6061 | MA | |
| Registered Dietitian | 133V00000X | 002338 | CT | Primary |
Addresses
Primary practice location
10 Jolley Dr
Bloomfield, CT 06002-3061
Mailing address
2 Meadow LN
Southampton, MA 01073-9417
Phone (413) 588-4728
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002338 | CT | MD | Professional Counselor |
| 6061 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1356037436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MEADOW LN",
"city": "SOUTHAMPTON",
"state": "MA",
"postal_code": "010739417",
"telephone_number": "413-588-4728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 JOLLEY DR",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060023061",
"telephone_number": "860-286-2470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIMMONS",
"first_name": "SAMANTHA",
"middle_name": "JANE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-12",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "6061",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CT",
"license": "002338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.