Active NPI
Nicole Hermosilla
- Registered Dietitian
- New Haven, CT
National Provider Identifier
1730538695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1029067
- Practice address
- 20 York Street Food and Nutrition
Epb806
New Haven, CT 06510-3220 - Phone
- (203) 688-3732
- NPI assigned
- Jun 10, 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 | 1029067 | Primary |
Addresses
Primary practice location
20 York Street Food and Nutrition
Epb806
New Haven, CT 06510-3220
Mailing address
20 York Street Food and Nutrition
Epb806
New Haven, CT 06510
Phone (203) 688-3732
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C02658 | Other | CT | MEDICARE YNHH MEDICARE NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1730538695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 YORK STREET FOOD AND NUTRITION",
"address_2": "EPB806",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06510",
"telephone_number": "203-688-3732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 YORK STREET FOOD AND NUTRITION",
"address_2": "EPB806",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065103220",
"telephone_number": "203-688-3732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMOSILLA",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-10",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "1029067",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE YNHH MEDICARE NUMBER",
"identifier": "C02658",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.