Nicole Berg

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

12 S 8TH St
Yakima, WA 98901-3020

Phone

(509) 454-4143

NPI assigned

Dec 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nicole Thompson Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Yakima Neighborhood Health Services

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1750985727
  Medicare reassignment NPD
• Yakima Neighborhood Health Services

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1285456772
  NPD
• Yakima Neighborhood Health Services

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1972869063
  NPD

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1922473149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S 8TH ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013020",
            "telephone_number": "509-454-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": "DI60623977",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RDN",
            "identifier": "86047366",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "THOMPSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Josefa Erica Benitez, MEDICAL ASSISTANT
• Michael Benitz
• Lisa Benoit, ARNP
• Darian Benskin
• Brandi Berg, ARNP
• Britta Lynn Bergan, MA MHC
• Rosemary Bergeron-Johnson, PAC
• Rebecca Marie Berghoff, RN BSN
• Bruce Alan Berglund, LMP
• Katarina Berk

• Registered Dietitian in Yakima, WA
• Providers in Yakima, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.