Individual provider Active NPI

Nicholas Milan Kijurna, RD, LDN

  • Registered Dietitian
  • Coconut Creek, FL
National Provider Identifier
1497222640
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86103572 Issued in IN
Practice address
7700 Renfrew LN
Coconut Creek, FL 33073-3508
Phone
(954) 698-9222
NPI assigned
Oct 25, 2018
Last updated
Oct 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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 86103572 IN Primary

Addresses

Primary practice location

7700 Renfrew LN
Coconut Creek, FL 33073-3508

Mailing address

7700 Renfrew LN
Coconut Creek, FL 33073-3508
Phone (954) 698-9222

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

State licenses

LicenseStateTypeSpecialty
86103572INMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1497222640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 RENFREW LN",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733508",
            "telephone_number": "954-698-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 RENFREW LN",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733508",
            "telephone_number": "954-698-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIJURNA",
        "first_name": "NICHOLAS",
        "middle_name": "MILAN",
        "name_prefix": "Mr.",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "86103572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.