Nicole Glick

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

002225 Issued in CT

Practice address

25 Newell Rd Ste C14
Bristol, CT 06010-5140

Phone

(850) 845-8367

NPI assigned

Sep 19, 2022

Last updated

Sep 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Gut Well LLC

  • Registered Dietitian
  • New London, CT
  • NPI 1093429680

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1891417507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 FITCH AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205330",
            "telephone_number": "301-908-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NEWELL RD STE C14",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105140",
            "telephone_number": "850-845-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "002225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Organization",
            "affiliation": "Y",
            "affiliationName": "Bristol Hospital Multi-Specialty Group, Inc.",
            "address_1": "25 Newell Rd Ste C14",
            "city": "Bristol",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060105140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chyenne Giarnese, APRN
• Emily C Gilbert
• Robert Giuliani, PHARMACIST
• Susan Glasser, MD
• Jennifer Glasson, PHARMD
• Megan Smith Godard, O.D.
• Sandra Jeanne Godin, LPC
• Olivia Ann Goforth, LCSW
• Bryan Douglas Goldberg, MD
• Jeffrey R Goldberg, MD

• Registered Dietitian in Bristol, CT
• Providers in Bristol, CT by specialty
• Registered Dietitian in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.

Verify at the official NPI Registry.