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GREAT BASIN NUTRITION LLC NPI 1053883520


NPI Information

NPI: 1053883520
Provider Name: GREAT BASIN NUTRITION LLC
Classification: Dietitian, Registered - 133V00000X
Entity Type: Organization

CLIA Number: 29D1080149

Address:
783 BASQUE WAY STE 103
CARSON CITY, NV
ZIP 89706
Phone: (775) 720-3490
Get Directions

GREAT BASIN NUTRITION LLC is a dietitian registered in Carson City, NV. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. GREAT BASIN NUTRITION LLC NPI is 1053883520. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

783 BASQUE WAY STE 103
CARSON CITY, NV
ZIP 89706-981
Phone: (775) 720-3490
Fax: (775) 245-2867

The provider's authorized official is Jodi Pettersen .
The authorized official title is Owner and has the following contact phone number (775) 720-3490.

The CLIA number assigned to this NPI record is 29D1080149 - other - o/p imaging center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2018 and was last updated on 12/21/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1133V00000XDietitian, RegisteredYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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