Individual provider Active NPI

Michelle M Nassib, C.N.

  • Nutritionist
  • El Dorado Hills, CA
National Provider Identifier
1578609558
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
001175 Issued in NJ
Practice address
7994 Ryland Dr
El Dorado Hills, CA 95762-9448
Phone
(609) 304-3006
NPI assigned
Jan 29, 2007
Last updated
Oct 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133N00000X
Nutritionist 133N00000X 001175 NJ Primary

Addresses

Primary practice location

7994 Ryland Dr
El Dorado Hills, CA 95762-9448

Mailing address

7994 Ryland Dr
El Dorado Hills, CA 95762-9448
Phone (609) 304-3006

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
001175NJMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1578609558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7994 RYLAND DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629448",
            "telephone_number": "609-304-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7994 RYLAND DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629448",
            "telephone_number": "609-304-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSIB",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "C.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NJ",
            "license": "001175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.