Active NPI
Nicole Kelly Woo, RDN
- Registered Dietitian
- Charlottesville, VA
National Provider Identifier
1548954670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86293369
- Practice address
- 4423 Chris Greene Lake Rd
Charlottesville, VA 22911-5814 - Phone
- (434) 962-9316
- NPI assigned
- Jun 2, 2023
- Sex
- Female
- 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 | 86293369 | VA | Primary |
Addresses
Primary practice location
4423 Chris Greene Lake Rd
Charlottesville, VA 22911-5814
Mailing address
4423 Chris Greene Lake Rd
Charlottesville, VA 22911-5814
Phone (434) 962-9316
Other names 1
- Nicole Kelly Glymph
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86293369 | VA | 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": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1548954670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4423 CHRIS GREENE LAKE RD",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229115814",
"telephone_number": "434-962-9316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4423 CHRIS GREENE LAKE RD",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229115814",
"telephone_number": "434-962-9316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOO",
"first_name": "NICOLE",
"middle_name": "KELLY",
"name_prefix": "Mrs.",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-02",
"last_updated": "2023-06-02",
"certification_date": "2023-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "VA",
"license": "86293369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "GLYMPH",
"middle_name": "KELLY",
"credential": "RDN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.