Individual provider Active NPI

Natalie Nicholas

  • Registered Dietitian
  • Ithaca, NY
National Provider Identifier
1538099494
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
009059-01 Issued in NY
Practice address
100 Fieldstone LN
Ithaca, NY 14850-9596
Phone
(607) 391-5387
NPI assigned
May 21, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2026

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 009059-01 NY Primary

Addresses

Primary practice location

100 Fieldstone LN
Ithaca, NY 14850-9596

Mailing address

100 Fieldstone LN
Ithaca, NY 14850-9596
Phone (607) 391-5387

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
009059-01NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1779321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1538099494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FIELDSTONE LN",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509596",
            "telephone_number": "607-391-5387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FIELDSTONE LN",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509596",
            "telephone_number": "607-391-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "NATALIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-21",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009059-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.