Individual provider Active NPI

Nichole L. Haynes, MS, RD, CSR, LDN

  • Renal Nutrition Registered Dietitian
  • Nashville, TN
National Provider Identifier
1376803700
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
1486 Issued in TN
Practice address
242 Orlando Ave
Nashville, TN 37209-3246
Phone
(615) 354-0053
Fax
(615) 354-1809
NPI assigned
May 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X 1486 TN Primary

Addresses

Primary practice location

242 Orlando Ave
Nashville, TN 37209-3246

Mailing address

107 Antler Ridge Cir
Nashville, TN 37214-4743
Phone (615) 513-3131

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1486TNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dialysis Associates, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1376803700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ANTLER RIDGE CIR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372144743",
            "telephone_number": "615-513-3131",
            "fax_number": "615-354-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 ORLANDO AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372093246",
            "telephone_number": "615-354-0053",
            "fax_number": "615-354-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "NICHOLE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "MS, RD, CSR, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "TN",
            "license": "1486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.