Active NPI
Noah Quezada, REGISTERED DIETITIAN
- Registered Dietitian
- Thornton, CO
National Provider Identifier
1568138352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86174135
- Practice address
- 12905 Lafayette St Unit E
Thornton, CO 80241-3952 - Phone
- (720) 579-5747
- NPI assigned
- Aug 20, 2021
- 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 | 86174135 | CO | Primary |
Addresses
Primary practice location
12905 Lafayette St Unit E
Thornton, CO 80241-3952
Mailing address
12905 Lafayette St Unit E
Thornton, CO 80241-3952
Phone (720) 579-5747
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 |
|---|---|---|---|
| 86174135 | CO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noahs Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1568138352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12905 LAFAYETTE ST UNIT E",
"city": "THORNTON",
"state": "CO",
"postal_code": "802413952",
"telephone_number": "720-579-5747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12905 LAFAYETTE ST UNIT E",
"city": "THORNTON",
"state": "CO",
"postal_code": "802413952",
"telephone_number": "720-579-5747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEZADA",
"first_name": "NOAH",
"credential": "REGISTERED DIETITIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-20",
"last_updated": "2021-08-20",
"certification_date": "2021-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "86174135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.