Individual provider Active NPI

Ingrid Sevilla Serrano, RDN

  • Registered Dietitian
  • Nampa, ID
National Provider Identifier
1932074713
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4271985 Issued in ID
Practice address
623 7TH Ave S
Nampa, ID 83651-4171
Phone
(814) 954-9980
NPI assigned
Oct 9, 2025
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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 4271985 ID Primary

Addresses

Primary practice location

623 7TH Ave S
Nampa, ID 83651-4171

Mailing address

623 7TH Ave S
Nampa, ID 83651-4171

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
4271985IDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Organizations & group practices 1

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": "1759968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1932074713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 7TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 7TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514171",
            "telephone_number": "814-954-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVILLA SERRANO",
        "first_name": "INGRID",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "4271985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.