WELLNESS IMPACT NUTRITION LLC NPI 1649660549

NPI Information

  • NPI: 1649660549
  • Provider Name: WELLNESS IMPACT NUTRITION, LLC
  • Classification: Dietitian, Registered - 133V00000X
  • Entity Type: Organization
  • Address: 1013 E WINDING CREEK DR
    SUITE 102
    EAGLE, ID
    ZIP 83616
  • Phone: (208) 250-5657

Map and Directions

Get Directions

NPI Details

WELLNESS IMPACT NUTRITION, LLC is a dietitian registered in Eagle, ID. 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. WELLNESS IMPACT NUTRITION, LLC NPI is 1649660549. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1013 E WINDING CREEK DR
SUITE 102
EAGLE, ID
ZIP 83616-060
Phone: (208) 250-5657
Fax: (208) 433-9424

The provider's authorized official is Deena M Lajoie .
The authorized official title is Owner/registered Dietitian and has the following contact phone number (208) 250-5657.

The enumeration date for this NPI number is 1/29/2015 and was last updated on 2/11/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133V00000XDietitian, RegisteredD-682IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11588936710MEDICAIDIDAHO

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.