Active NPI
Michele Nicolo
- Registered Dietitian
- Los Angeles, CA
National Provider Identifier
1699187294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 897889
- Practice address
- 1000 Veteran Avenue Suite A641
Los Angeles, CA 90095-4133 - Phone
- (310) 825-8173
- NPI assigned
- May 30, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN003453 | PA | |
| Registered Dietitian | 133V00000X | 897889 | CA | Primary |
Addresses
Primary practice location
1000 Veteran Avenue Suite A641
Los Angeles, CA 90095-4133
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 897889 | CA | MD | Registered Dietitian |
| DN003453 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cloud Health Medical Group, P.a. | Past | Accepting new patients | |
| Cloud Health Medical Group of New Jersey, P.C. | Past | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Cloud Health Medical Group of California, P.C. | Past | Accepting new patients | |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 5
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.
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-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635724800000",
"number": "1699187294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 VETERAN AVENUE SUITE A641",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900954133",
"telephone_number": "310-825-8173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLO",
"first_name": "MICHELE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-30",
"last_updated": "2021-11-01",
"certification_date": "2021-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN003453",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "897889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.