NICOLE WAKE (NPI# 1073990362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073990362 |
| Entity Type | Individual |
| Full Name | NICOLE WAKE |
| Credential | M.S., R.D. |
| Practice Address |
179 N Broad St Norwich NY 13815-1019 |
| Mailing Address |
145 Co Rd 32a Norwich NY 13815 |
| Practice Telephone | 6073374812 |
| Practice Fax Number | 6073374198 |
| Mailing Telephone | 6073737410 |
| Mailing Fax Number | 6073374198 |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2020-07-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 1019080 | NY | Dietary & Nutritional Service Providers |
| Street Address |
179 N BROAD ST |
| City | NORWICH |
| State | NY |
| Zip Code | 13815-1019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265431993 | Ronald H Sacks | Radiology | 179 N Broad St, Norwich, NY 13815-1019 | 2005-07-15 |
| 1770138448 | Jessica Marie Banning | Physical Therapist | 179 N Broad St, Norwich, NY 13815-1019 | 2019-08-08 |
| 1467007799 | Sayde Shea Gaydorus | Occupational Therapist | 179 N Broad St, Norwich, NY 13815-1019 | 2019-08-05 |
| 1336625243 | Alyssa Clare Macintosh | Obstetrics & Gynecology | 179 N Broad St, Norwich, NY 13815-1019 | 2018-07-13 |
| 1568975159 | Chenango Memorial Hospital Inc | Clinic/Center | 179 N Broad St, Norwich, NY 13815-1019 | 2017-11-06 |
| 1154831295 | Janice Minutti | Dietitian, Registered | 179 N Broad St, Norwich, NY 13815-1019 | 2017-10-03 |
| 1538678388 | Ektaben Miteshkumar Chauhan | Physical Therapist | 179 N Broad St, Norwich, NY 13815-1019 | 2017-09-25 |
| 1194234005 | Kristen Kay Menard | Nurse Practitioner | 179 N Broad St, Norwich, NY 13815-1019 | 2017-09-22 |
| 1679092779 | Lindsay Jae Skiechs | Dietitian, Registered | 179 N Broad St, Norwich, NY 13815-1019 | 2017-09-11 |
| 1154771681 | Nicholas Trinkle | Dietitian, Registered | 179 N Broad St, Norwich, NY 13815-1019 | 2016-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497304752 | Amanda Butler | Social Worker | Chenango County Community Mental Hygiene Services, 5 Court Street, Suite 42 County Office Building, Norwich, NY 13815 | 2019-09-10 |
| 1235793548 | Kay Marie Drebert | Social Worker | Chenango County Community Mental Hygiene Services - Cou, Suite 42, Norwich, NY 13815 | 2019-04-23 |
| 1497230460 | Jessica Lynn Elliott | Social Worker | 5 Court Street, St 42, Chenango County Behavioral Health Services, County Offi, Norwich, NY 13815 | 2018-09-26 |
| 1801387543 | Heather Rae Kolb | Social Worker | 5 Court St. Suite 42, Noriwch, NY 13815 | 2018-05-29 |
| 1386162006 | Courtney Jean Brown | Licensed Practical Nurse | 131 Railroad Ave, Norwich, NY 13815 | 2017-09-01 |
| 1891225827 | Fanny Sacks | Chiropractor | 4939 State Hwy 23, Norwich, NY 13815 | 2017-06-13 |
| 1558817916 | Erika J Rossi | Nurse Practitioner | 55 Calvary Drive, Norwich, NY 13815 | 2016-08-26 |
| 1013367341 | Irina Gordeyeva | Social Worker | 5 Court Street Suite 42, Chenango County Behavioral Health Services, Norwich, NY 13815 | 2016-06-17 |
| 1104287390 | Amanda Leigh Scott | Massage Therapist | 409 County Rd 33, Norwich, NY 13815 | 2016-03-15 |
| 1962886119 | Abigail Goings | Speech-Language Pathologist | 54 Borden Ave, C 38, Norwich, NY 13815 | 2015-07-17 |
| Find all providers in zip 13815 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942739941 | Alison Dvorak | Dietitian, Registered | 19 Ohio Ave Ste 2, Norwich, CT 06360-1599 | 2017-06-05 |
| 1740359868 | Mary Beth Green | Dietitian, Registered | William W Backus Hospital, 326 Washington St, Norwich, CT 06360 | 2006-11-06 |
| 1154831295 | Janice Minutti | Dietitian, Registered | 179 N Broad St, Norwich, NY 13815-1019 | 2017-10-03 |
| 1679092779 | Lindsay Jae Skiechs | Dietitian, Registered | 179 N Broad St, Norwich, NY 13815-1019 | 2017-09-11 |
| 1154771681 | Nicholas Trinkle | Dietitian, Registered | 179 N Broad St, Norwich, NY 13815-1019 | 2016-06-15 |
| 1952587040 | Jennifer L Stremcha | Dietitian, Registered | 326 Washington St, Food and Nutrition Services, Norwich, CT 06360-2740 | 2008-01-18 |
| 1366636268 | Gayle L Breuilly | Dietitian, Registered | 179 N Broad St, Norwich, NY 13815-1019 | 2007-09-04 |
| 1144344839 | Amy W Tuller | Dietitian, Registered | 303 Us Route 5 S, #5, Norwich, VT 05055-9508 | 2007-03-19 |
| 1851460067 | Joan Sommers | Dietitian, Registered | 111 Salem Turnpike, Backus Outpatient Care Center, Norwich, CT 06360 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013910 | Kelsey Rose Schaffstall | Dietitian, Registered | 52 Ashley Dr, West Seneca, NY 14224-4357 | 2020-11-06 |
| 1013518232 | Leslie Wayte Heineman | Dietitian, Registered | 220 Evandale Rd, Scarsdale, NY 10583-1530 | 2020-11-04 |
| 1205437423 | Christine Clement | Dietitian, Registered | 319 W 76th St Apt 4, New York, NY 10023-8045 | 2020-11-04 |
| 1578164745 | Suzanne Finkel | Dietitian, Registered | 215 Saint James Pl Apt 1a, Brooklyn, NY 11238-2374 | 2020-11-04 |
| 1427659788 | Sabroso Nutrition, LLC | Dietitian, Registered | 2818 Morris Ave, Bronx, NY 10468-2802 | 2020-11-03 |
| 1780285320 | Khy Ee Siew | Dietitian, Registered | 3 Horizon Rd, Great Neck, NY 11020-1143 | 2020-11-02 |
| 1699376285 | Naudia V Jones | Dietitian, Registered | 2111 Foster Ave Apt 1b, Brooklyn, NY 11210-1016 | 2020-11-02 |
| 1982203519 | Grace Young Ko | Dietitian, Registered | 15009 Northern Blvd Fl 4, Flushing, NY 11354-3888 | 2020-10-24 |
| 1538768247 | Rose Urkevich | Dietitian, Registered | 65 Lake Shore Dr, Troy, NY 12180-9722 | 2020-10-23 |
| 1083213763 | Sarah Bourdet | Dietitian, Registered | 4314 60th St Apt 4b, Woodside, NY 11377-4914 | 2020-10-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.