DR. DANIELA NOVOTNY (RD, LD, CHES) – Registered Dietitian, NPI 1467695304
Registered Dietitian
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. DANIELA NOVOTNY (RD, LD, CHES)
Citizens Memorial Hospital, 1500, North Oakland Avenue, Bolivar, Polk County, Missouri, 65613, United States
BOLIVAR, MO 656133011
Phone: (417) 328-6737
Fax: (417) 328-6649
Type: Location
2236, West Springlane Street, Springfield, Greene County, Missouri, 65807, United States
SPRINGFIELD, MO 658074036
Phone: (417) 883-5122
Type: Mailing
3847 W EDGEWOOD ST
SPRINGFIELD, MO 658075586
Phone: (417) 619-8981
Type: Mailing
901 S NATIONAL AVE
SPRINGFIELD, MO 658970027
Phone: (417) 619-8981
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-03-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170322000138 | I | Registered Dietitian Or Nutrition Professional | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 65613)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Nurse Practitioner | MO | |
| Internal Medicine | WA | |
| Family Practice | MO | |
| - | MO | |
| - | MO | |
| Osteopathic Manipulative Medicine | MO | |
| - | MO | |
| - | MO | |
| Family Practice | MO |
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