Active NPI
Nicole Dion Santonastaso, RDN, CLC, IBCLC, CDE
- Registered Dietitian
- Phoenix, AZ
National Provider Identifier
1396208625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 1920 E Cambridge Ave
Phoenix, AZ 85006-1459 - Phone
- (602) 933-0618
- NPI assigned
- Apr 12, 2019
- Last updated
- Aug 6, 2019
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | |||
| Doula | 374J00000X | |||
| Lactation Consultant (Non-RN) | 174N00000X | |||
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
1920 E Cambridge Ave
Phoenix, AZ 85006-1459
Mailing address
3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1813
Other practice location 1
5414 N 79th Way
Scottsdale, AZ 85250-7622
Phone (978) 696-1768
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 529668 | Medicaid | AZ |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1396208625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 E CAMELBACK RD STE 250",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850182327",
"telephone_number": "602-933-1813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 E CAMBRIDGE AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850061459",
"telephone_number": "602-933-0618"
}
],
"practiceLocations": [
{
"address_1": "5414 N 79th Way",
"address_purpose": "LOCATION",
"city": "Scottsdale",
"state": "AZ",
"postal_code": "852507622",
"country_code": "US",
"telephone_number": "978-696-1768",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANTONASTASO",
"first_name": "NICOLE",
"middle_name": "DION",
"name_prefix": "Miss",
"credential": "RDN, CLC, IBCLC, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-12",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": null,
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": null,
"license": null,
"primary": false
},
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "529668",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.