Individual provider Active NPI

Todd William Niemietz, RD

  • Registered Dietitian
  • Saint Louis, MO
National Provider Identifier
1679316145
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.000000 Issued in IL
Practice address
9732 Wilderness Battle Cir
Saint Louis, MO 63123-4336
Phone
(618) 719-4275
NPI assigned
Jun 13, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 2014011385 MO
Registered Dietitian 133V00000X 164.000000 IL Primary

Addresses

Primary practice location

9732 Wilderness Battle Cir
Saint Louis, MO 63123-4336

Mailing address

9732 Wilderness Battle Cir
Saint Louis, MO 63123-4336
Phone (618) 719-4275

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
164.000000ILMDNutritionist
2014011385MOMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Sia Medical PC Single Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: todd.niemietz.2@25522.direct.athenahealth.com

Organizations & group practices 2

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": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1679316145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9732 WILDERNESS BATTLE CIR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631234336",
            "telephone_number": "618-719-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9732 WILDERNESS BATTLE CIR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631234336",
            "telephone_number": "618-719-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMIETZ",
        "first_name": "TODD",
        "middle_name": "WILLIAM",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2014011385",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.