Individual provider Active NPI

Nicole Tagge, RD

  • Registered Dietitian
  • Montoursville, PA
National Provider Identifier
1376434472
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN006059 Issued in PA
Practice address
288 Fairfield Church Rd
Montoursville, PA 17754-8104
Phone
(570) 772-2991
NPI assigned
Jul 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X DN006059 PA Primary

Addresses

Primary practice location

288 Fairfield Church Rd
Montoursville, PA 17754-8104

Mailing address

288 Fairfield Church Rd
Montoursville, PA 17754-8104
Phone (570) 772-2991

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
DN006059PAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1376434472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 FAIRFIELD CHURCH RD",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177548104",
            "telephone_number": "570-772-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 FAIRFIELD CHURCH RD",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177548104",
            "telephone_number": "570-772-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGGE",
        "first_name": "NICOLE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN006059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montoursville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.