Active NPI
Nicole Lynn Gerhold, RD, LRD
- Registered Dietitian
- Fargo, ND
National Provider Identifier
1639624877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1021
- Practice address
- 801 Broadway N
Fargo, ND 58102-3641 - Phone
- (701) 234-6604
- NPI assigned
- Aug 17, 2016
- 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 | 1021 | ND | Primary |
Addresses
Primary practice location
801 Broadway N
Fargo, ND 58102-3641
Mailing address
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-6604
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471392000000",
"number": "1639624877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581023641",
"telephone_number": "701-234-6604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581023641",
"telephone_number": "701-234-6604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERHOLD",
"first_name": "NICOLE",
"middle_name": "LYNN",
"name_prefix": "Miss",
"credential": "RD, LRD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-17",
"last_updated": "2016-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ND",
"license": "1021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.