Active NPI
Nicole Mae Smith, RD, CDN
- Registered Dietitian
- Vestal, NY
National Provider Identifier
1922570209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 008834
- Practice address
- 213 Tracy Creek Rd
Vestal, NY 13850-1062 - Phone
- (607) 217-6513
- Fax
- (607) 786-9060
- NPI assigned
- Dec 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 008834 | NY | Primary |
Addresses
Primary practice location
213 Tracy Creek Rd
Vestal, NY 13850-1062
Mailing address
249 Glenwood Rd
Binghamton, NY 13905-1695
Phone (607) 217-6513
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008834 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545782400000",
"number": "1922570209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "249 GLENWOOD RD",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139051695",
"telephone_number": "607-217-6513",
"fax_number": "607-786-9060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 TRACY CREEK RD",
"city": "VESTAL",
"state": "NY",
"postal_code": "138501062",
"telephone_number": "607-217-6513",
"fax_number": "607-786-9060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "NICOLE",
"middle_name": "MAE",
"credential": "RD, CDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-26",
"last_updated": "2018-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "008834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.