Individual provider Active NPI

Lauren Nicole Cadillac, REGISTERED DIETITIAN

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1922506328
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86020380 Issued in NJ
Practice address
576 5TH Ave Ste 805
New York, NY 10036-4826
Phone
(201) 873-3832
NPI assigned
Jan 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86020380 NJ Primary

Addresses

Primary practice location

576 5TH Ave Ste 805
New York, NY 10036-4826

Mailing address

107 E 63Rd St Apt 1B
New York, NY 10065-7346
Phone (201) 873-3832

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

State licenses

LicenseStateTypeSpecialty
86020380NJMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1922506328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E 63RD ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657346",
            "telephone_number": "201-873-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 5TH AVE STE 805",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364826",
            "telephone_number": "201-873-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADILLAC",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "86020380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.