Nicole Shay Fennell, MS, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

133V00000X Issued in TX

Practice address

4530 Briar Hollow PL
#120
Houston, TX 77027-9750

Phone

(512) 635-4417

NPI assigned

Jan 6, 2012

Last updated

Feb 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jason R Bailey MD PA

  • Plastic and Reconstructive Surgery Physician
  • Houston, TX
  • NPI 1699054270
  NPD (past)

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1396015327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E TC JESTER BLVD STE 135",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081454",
            "telephone_number": "713-800-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 BRIAR HOLLOW PL",
            "address_2": "#120",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770279750",
            "telephone_number": "512-635-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "NICOLE",
        "middle_name": "SHAY",
        "name_prefix": "Mrs.",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": "133NN1002X",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "133V00000X",
            "primary": true
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "NU",
            "license": "133VN1005X",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NU",
            "license": "113VN1006X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yi Feng, M.D.
• Zihang Feng
• Jacqueline Ann Fenn, MD PHD
• Brianna Fennell
• David Fennell, PTA
• Alicia S Fennemore, MA, CCC-SLP
• Theresa Marie Fennessey, LMT
• Kae Marie Fenster, RD
• Olivia St Romain Fenstermaker, OTR
• Wayne Lynn Fenton, HIS

• Registered Dietitian in Houston, TX
• Providers in Houston, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.