Individual provider Active NPI

Nicole Knecht, RD

  • Registered Dietitian
  • Geneva, IL
National Provider Identifier
1912223793
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164006965 Issued in IL
Practice address
308 Randall Rd Ste B
Geneva, IL 60134-4201
Phone
(630) 315-1700
Fax
(630) 938-8330
NPI assigned
Apr 19, 2010
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164006965 IL Primary
Pediatric Nutrition Registered Dietitian 133VN1004X 1458 KS

Addresses

Primary practice location

308 Randall Rd Ste B
Geneva, IL 60134-4201

Mailing address

308 Randall Rd Ste B
Geneva, IL 60134-4201
Phone (630) 315-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210913000538 IL Practitioner - Registered Dietitian Or Nutrition Professional 0244364446 Reassigns benefits to 1 organization
I20250113003534 TX Practitioner - Registered Dietitian Or Nutrition Professional 0244364446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

308 Randall Rd
Suite B
Geneva, IL 60134-4201
Phone (630) 262-6077

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164006965ILMDRegistered Dietitian
1458KSMDPediatric Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Sep 1, 2021 Accepting new patients
Nourish, Inc. Dietitian, Registered CurrentSince Dec 9, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

308 Randall Rd
Ste B
Geneva, IL 60134
Phone (630) 262-0279

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Organizations & group practices 3

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1912223793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 RANDALL RD STE B",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344201",
            "telephone_number": "630-315-1700",
            "fax_number": "630-938-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 RANDALL RD STE B",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344201",
            "telephone_number": "630-315-1700",
            "fax_number": "630-938-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNECHT",
        "first_name": "NICOLE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164006965",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "KS",
            "license": "1458",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.