Active NPI
Corey Ann Tolbert, RDN, LD
- Registered Dietitian
- Senoia, GA
National Provider Identifier
1518406842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD003008
- Practice address
- 20 Charleston Dr
Senoia, GA 30276 - Phone
- (770) 855-5903
- NPI assigned
- Feb 20, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD003008 | GA | Primary |
Addresses
Primary practice location
20 Charleston Dr
Senoia, GA 30276
Mailing address
20 Charleston Dr
Senoia, GA 30276-2358
Phone (770) 855-5903
Other names 1
- Corey Ann Cassise
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
| License | State | Type | Specialty |
|---|---|---|---|
| LD003008 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1518406842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 CHARLESTON DR",
"city": "SENOIA",
"state": "GA",
"postal_code": "302762358",
"telephone_number": "770-855-5903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 CHARLESTON DR",
"city": "SENOIA",
"state": "GA",
"postal_code": "30276",
"telephone_number": "770-855-5903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLBERT",
"first_name": "COREY",
"middle_name": "ANN",
"credential": "RDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-20",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD003008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "COREY",
"last_name": "CASSISE",
"middle_name": "ANN",
"credential": "RDN, LD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Senoia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.