Active NPI
Nicole Victoria Dann-Payne, MS, RD, LDN
- Registered Dietitian
- Indiana, PA
National Provider Identifier
1942595400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN004515
- Practice address
- 714 Philadelphia St
Indiana, PA 15701-3955 - Phone
- (570) 994-4066
- NPI assigned
- Jun 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | DN004515 | PA | Primary |
Addresses
Primary practice location
714 Philadelphia St
Indiana, PA 15701-3955
Mailing address
255 Chestnut St
Indiana, PA 15701-2032
Phone (570) 994-4066
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN004515 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1942595400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 CHESTNUT ST",
"city": "INDIANA",
"state": "PA",
"postal_code": "157012032",
"telephone_number": "570-994-4066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 PHILADELPHIA ST",
"city": "INDIANA",
"state": "PA",
"postal_code": "157013955",
"telephone_number": "570-994-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANN-PAYNE",
"first_name": "NICOLE",
"middle_name": "VICTORIA",
"name_prefix": "Mrs.",
"credential": "MS, RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-13",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN004515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indiana, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.