Active NPI
Tabitha Nicholas, M.S., RD, LDN
- Registered Dietitian
- Lake Charles, LA
National Provider Identifier
1407175888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2038
- Practice address
- 114 State St
Lake Charles, LA 70605-5718 - Phone
- (337) 419-0942
- Fax
- (337) 314-1243
- NPI assigned
- May 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 2038 | LA | |
| Renal Nutrition Registered Dietitian | 133VN1005X | 2038 | LA | |
| Registered Dietitian | 133V00000X | 2038 | LA | Primary |
Addresses
Primary practice location
114 State St
Lake Charles, LA 70605-5718
Mailing address
3201 Flatwood Dr
Lake Charles, LA 70607-4324
Phone (337) 419-0942
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1407175888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 FLATWOOD DR",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706074324",
"telephone_number": "337-419-0942",
"fax_number": "337-314-1243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 STATE ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706055718",
"telephone_number": "337-419-0942",
"fax_number": "337-314-1243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "TABITHA",
"credential": "M.S., RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-24",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "LA",
"license": "2038",
"primary": false
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "LA",
"license": "2038",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "2038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.