Active NPI
Gayla Nicholson, RD
- Registered Dietitian
- Livingston, MT
National Provider Identifier
1952514952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 318
- Practice address
- 320 N Main St Ste 3
Livingston, MT 59047-2000 - Phone
- (406) 220-3268
- NPI assigned
- May 7, 2007
- 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 | 318 | MT | Primary |
Addresses
Primary practice location
320 N Main St Ste 3
Livingston, MT 59047-2000
Mailing address
PO Box 947
Livingston, MT 59047-0947
Phone (406) 220-3268
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0280514 | Medicaid | MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2018 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 318 | MT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1952514952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 947",
"city": "LIVINGSTON",
"state": "MT",
"postal_code": "590470947",
"telephone_number": "406-220-3268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 N MAIN ST STE 3",
"city": "LIVINGSTON",
"state": "MT",
"postal_code": "590472000",
"telephone_number": "406-220-3268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "GAYLA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MT",
"license": "318",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0280514",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Livingston, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.