Individual provider Active NPI

Nicole Morrissey, RD, CDCES, BC-ADM

  • Registered Dietitian
  • Delaware, OH
National Provider Identifier
1376775643
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
567 Bettmann St
Delaware, OH 43015-3454
Phone
(740) 513-3510
NPI assigned
Aug 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

567 Bettmann St
Delaware, OH 43015-3454

Mailing address

3900 Hollywood Road
St. Joseph, MI 49085
Phone (708) 945-4502

Other names 1

  • Nicole R Nelson Former name

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

LicenseStateTypeSpecialty
6569OHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1376775643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 HOLLYWOOD ROAD",
            "city": "ST. JOSEPH",
            "state": "MI",
            "postal_code": "49085",
            "telephone_number": "708-945-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 BETTMANN ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430153454",
            "telephone_number": "740-513-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISSEY",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "RD, CDCES, BC-ADM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-19",
        "last_updated": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "NELSON",
            "middle_name": "R",
            "credential": "MS, RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Delaware, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.