Active NPI
Nicholas John Bogdis, RDN
- Registered Dietitian
- Pinon Hills, CA
National Provider Identifier
1528848355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86211240
- Practice address
- 10633 Crystal Aire Rd.
Pinon Hills, CA 92372 - Phone
- (909) 698-0038
- NPI assigned
- Sep 29, 2023
- Last updated
- Sep 29, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 86211240 | CA | Primary |
Addresses
Primary practice location
10633 Crystal Aire Rd.
Pinon Hills, CA 92372
Mailing address
PO Box 721497
Pinon Hills, CA 92372-1497
Phone (909) 698-0038
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 |
|---|---|---|---|
| 86211240 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New 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": "1695945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695945600000",
"number": "1528848355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 721497",
"city": "PINON HILLS",
"state": "CA",
"postal_code": "923721497",
"telephone_number": "909-698-0038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10633 CRYSTAL AIRE RD.",
"city": "PINON HILLS",
"state": "CA",
"postal_code": "92372",
"telephone_number": "909-698-0038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGDIS",
"first_name": "NICHOLAS",
"middle_name": "JOHN",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-29",
"last_updated": "2023-09-29",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86211240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinon Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.