Active NPI
Nicole Karmae Charbonneau
- Registered Dietitian
- Fort Polk, LA
National Provider Identifier
1942390604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT06681
- Practice address
- 1585 3Rd St
Fort Polk, LA 71459-5102 - Phone
- (337) 531-3893
- NPI assigned
- Oct 13, 2006
- 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 | DT06681 | TX | Primary |
Addresses
Primary practice location
1585 3Rd St
Fort Polk, LA 71459-5102
Mailing address
5997 Harrell PL Apt B
Fort Polk, LA 71459-3687
Phone (337) 531-2068
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
| License | State | Type | Specialty |
|---|---|---|---|
| DT06681 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942390604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5997 HARRELL PL APT B",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714593687",
"telephone_number": "337-531-2068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 3RD ST",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714595102",
"telephone_number": "337-531-3893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARBONNEAU",
"first_name": "NICOLE",
"middle_name": "KARMAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT06681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Polk, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.