Individual provider Active NPI

Nicole L Myers, RD

  • Registered Dietitian
  • Amherst, MA
National Provider Identifier
1881976884
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2910 Issued in MA
Practice address
25 Pray St
Amherst, MA 01002-2110
Phone
(917) 626-1027
Fax
(413) 707-1027
NPI assigned
Sep 15, 2011
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 998049 VT
Registered Dietitian 133V00000X 998049 NC
Registered Dietitian 133V00000X L004854 NC
Registered Dietitian 133V00000X 2910 MA Primary

Addresses

Primary practice location

25 Pray St
Amherst, MA 01002-2110

Mailing address

3 Phillips PL
Hadley, MA 01035-3515
Phone (917) 626-1027

Other practice location 1

7909 Shadow Oaks Dr Apt 935
Charlotte, NC 28269-4393
Phone (802) 355-2238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807000605 MA Practitioner - Registered Dietitian Or Nutrition Professional 4981853702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of Vermont College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Happy Valley Nutrition PCGroup PAC ID 4486047800, 3 clinicians

Practice addresses (Care Compare)

25 Pray St
Suite 101
Amherst, MA 01002-2110
Phone (203) 828-0028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
998049NCMDRegistered Dietitian
L004854NCMDRegistered Dietitian
998049VTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Happy Valley Nutrition PC Dietitian, Registered CurrentSince Jul 15, 2023 Accepting new patients

Locations

25 Pray St
Ste 101
Amherst, MA 01002
Phone (203) 828-0028

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1881976884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PHILLIPS PL",
            "city": "HADLEY",
            "state": "MA",
            "postal_code": "010353515",
            "telephone_number": "917-626-1027",
            "fax_number": "413-707-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PRAY ST",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022110",
            "telephone_number": "917-626-1027",
            "fax_number": "413-707-1027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7909 Shadow Oaks Dr Apt 935",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282694393",
            "country_code": "US",
            "telephone_number": "802-355-2238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VT",
            "license": "998049",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "998049",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004854",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.