Active NPI
Nicole Ann Bruns, MNT
- Registered Dietitian
- Toledo, OH
National Provider Identifier
1952300147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4616
- Practice address
- 4235 Secor Rd
Toledo, OH 43623-4299 - Phone
- (419) 469-6884
- Fax
- (888) 363-3695
- NPI assigned
- Jul 19, 2005
- 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 | 4616 | OH | Primary |
Addresses
Primary practice location
4235 Secor Rd
Toledo, OH 43623-4299
Mailing address
1012 Lones Dr
Perrysburg, OH 43551-2332
Phone (419) 356-7504
Other practice location 1
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0368346 | Medicaid | OH |
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 |
|---|---|---|---|
| 4616 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738281600000",
"number": "1952300147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1012 LONES DR",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435512332",
"telephone_number": "419-356-7504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4235 SECOR RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436234299",
"telephone_number": "419-469-6884",
"fax_number": "888-363-3695"
}
],
"practiceLocations": [
{
"address_1": "2142 N Cove Blvd",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436063895",
"country_code": "US",
"telephone_number": "419-291-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRUNS",
"first_name": "NICOLE",
"middle_name": "ANN",
"credential": "MNT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-19",
"last_updated": "2025-01-31",
"certification_date": "2025-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "4616",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0368346",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.