NUTRITION FIRST LLC - NPI NUMBER 1679875124

Summary

Provider Name: NUTRITION FIRST LLC

NPI Number: 1679875124

Clasification: Dietitian, Registered (133V00000X)

Address:
415 RTE 34 N
SUITE 107
COLTS NECK, NJ
ZIP 07722

Phone Number: (908) 692-4140



Detailed Information

NUTRITION FIRST LLC is a registered dietitian in Colts Neck, NJ. The provider is 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. The assigned NPI number for this provider is 1679875124 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

415 RTE 34 N
SUITE 107
COLTS NECK, NJ
ZIP 07722-017
Phone: (908) 692-4140
Fax: (732) 946-1177

The provider's authorized official is Luanne Wright Petrie .
The authorized official title is Direct Owner and has the following contact phone number (908) 692-4140.

The enumeration date for this NPI number is 12/2/2010 and was last updated on 12/2/2010.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 133V00000X Dietitian, Registered 610878 NY Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1679875124 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name NUTRITION FIRST LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 415 RTE 34 N The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Second Line Business Practice Location Address SUITE 107 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name COLTS NECK The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name NJ The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 077221017 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 9086924140 The telephone number associated with the location address of the provider being identified.
12 Provider Business Practice Location Address Fax Number 7329461177 The fax number associated with the location address of the provider being identified.
13 Provider Enumeration Date 12/2/2010 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 12/2/2010 The date that a record was last updated or changed.
15 Authorized Official Last Name PETRIE The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name LUANNE The first name of the authorized official.
17 Authorized Official Middle Name WRIGHT The middle name of the authorized official.
18 Authorized Official Title or Position DIRECT OWNER The title or position of the authorized official.
19 Authorized Official Telephone Number 9086924140 The 10-position telephone number of the authorized official.
20 Healthcare Provider Taxonomy Code 1 133V00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
21 Provider License Number 1 610878 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
22 Provider License Number State Code 1 NY The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
23 Healthcare Provider Primary Taxonomy Switch 1 Y
24 Is Organization Subpart N
25 Authorized Official Name Prefix Text MRS.
26 Authorized Official Credential Text MS, RD, CDE
27 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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