Active NPI
Nikola Backiel, MS, RDN, LDN, CLC
- Registered Dietitian
- Port St Lucie, FL
National Provider Identifier
1609765171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND12435
- Practice address
- 150 SW South Wakefield Cir
Port St Lucie, FL 34953-5447 - Phone
- (772) 233-9754
- NPI assigned
- Jun 30, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | ALPP-354436 | MA | |
| Registered Dietitian | 133V00000X | ND12435 | FL | Primary |
Addresses
Primary practice location
150 SW South Wakefield Cir
Port St Lucie, FL 34953-5447
Mailing address
150 SW South Wakefield Cir
Port St Lucie, FL 34953-5447
Phone (772) 233-9754
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND12435 | FL | MD | Registered Dietitian |
| ALPP-354436 | MA | MD | Lactation Consultant (Non-RN) |
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": "1751241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751241600000",
"number": "1609765171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 SW SOUTH WAKEFIELD CIR",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349535447",
"telephone_number": "772-233-9754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 SW SOUTH WAKEFIELD CIR",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349535447",
"telephone_number": "772-233-9754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACKIEL",
"first_name": "NIKOLA",
"credential": "MS, RDN, LDN, CLC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-30",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "MA",
"license": "ALPP-354436",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND12435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.