Individual provider Active NPI

Nicole D Kemp, RD, LDN

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1568654770
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
949149 Issued in PA
Practice address
3330 Grant Ave
Philadelphia, PA 19114-2600
Phone
(267) 257-7996
Fax
(215) 464-7638
NPI assigned
Aug 11, 2007
Last updated
Oct 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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 949149 PA Primary

Addresses

Primary practice location

3330 Grant Ave
Philadelphia, PA 19114-2600

Mailing address

534 W Midvale Ave
Philadelphia, PA 19144-4618
Phone (267) 257-7996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090618000192 PA Practitioner - Registered Dietitian Or Nutrition Professional 2769532415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

501 Cambria Ave
Bensalem, PA 19020-7213
Phone (888) 383-7167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
949149PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
All About Nutrition LLC Dietitian, Registered CurrentSince Jan 11, 2010 Accepting new patients
Mindful Eating Company LLC Dietitian, Registered Past Accepting new patients
Kingley Health Services NJ LLC Past Accepting new patients

Locations

501 Cambria Ave
Bensalem, PA 19020
Phone (215) 720-4640

3330 Grant Ave
Philadelphia, PA 19114
Phone (267) 257-7996

Organizations & group practices 3

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": "1186790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1568654770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 W MIDVALE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444618",
            "telephone_number": "267-257-7996",
            "fax_number": "215-464-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142600",
            "telephone_number": "267-257-7996",
            "fax_number": "215-464-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "NICOLE",
        "middle_name": "D",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-11",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "949149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.