Active NPI
Nicole Theriault, RD, LD
- Registered Dietitian
- Presque Isle, ME
National Provider Identifier
1962593665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D1710
- Practice address
- 140 Academy St
Presque Isle, ME 04769-3102 - Phone
- (207) 768-4358
- NPI assigned
- Sep 27, 2006
- 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 | D1710 | ME | Primary |
Addresses
Primary practice location
140 Academy St
Presque Isle, ME 04769-3102
Mailing address
39 Echo Lake Rd
Presque Isle, ME 04769-5252
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 |
|---|---|---|---|
| D1710 | ME | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1962593665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 ECHO LAKE RD",
"city": "PRESQUE ISLE",
"state": "ME",
"postal_code": "047695252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 ACADEMY ST",
"city": "PRESQUE ISLE",
"state": "ME",
"postal_code": "047693102",
"telephone_number": "207-768-4358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THERIAULT",
"first_name": "NICOLE",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ME",
"license": "D1710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Presque Isle, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.