Active NPI
Rebecca Hicklin, RD
- Registered Dietitian
- Simpsonville, SC
National Provider Identifier
1679180087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1961
- Practice address
- 125 Sedgebrook Dr
Simpsonville, SC 29681-3541 - Phone
- (864) 350-8885
- NPI assigned
- Sep 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 1961 | SC | Primary |
Addresses
Primary practice location
125 Sedgebrook Dr
Simpsonville, SC 29681-3541
Mailing address
125 Sedgebrook Dr
Simpsonville, SC 29681-3541
Phone (864) 350-8885
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | rebecca@palmettonutrition.com | Direct | Palmetto Nutrition Consultants |
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 |
|---|---|---|---|
| 1961 | SC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmetto Nutrition Consultants | Dietitian, Registered | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Registered Dietitian
- Simpsonville, SC
- NPI 1710584982
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1679180087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 SEDGEBROOK DR",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296813541",
"telephone_number": "864-350-8885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 SEDGEBROOK DR",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296813541",
"telephone_number": "864-350-8885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKLIN",
"first_name": "REBECCA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-29",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "1961",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "rebecca@palmettonutrition.com",
"affiliation": "Y",
"endpointDescription": "Business Email",
"affiliationName": "Palmetto Nutrition Consultants",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "125 Sedgebrook Dr",
"city": "Simpsonville",
"state": "SC",
"country_code": "US",
"postal_code": "296813541",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Simpsonville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.