Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole Samantha Sares

Individual provider Registered Dietitian · NPI 1164993978

Nicole Samantha Sares is a Registered Dietitian OR Nutrition Professional in Ashtabula, Ohio. Qualified in 2011, 15 years ago. Licensed in Illinois and Ohio.

Years since qualifying
15
Licensed in
IL, OH
In the registry since
2018
Specialties on file
2

Practice location Address checks out

3225 Lake Ave
Ashtabula, OH 44004-5758
Phone: (440) 998-7515
Fax: (440) 998-0973
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 1049341 (IL)
Registered Dietitian Taxonomy 133V00000X · Licence LD.6996 (OH)

Record details

NPI number1164993978
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 6, 2018
Last updated in NPPESDecember 6, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Ashtabula