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THREE RIVERS HEALTH NUTRITIONAL SERVICES NPI 1205165115


NPI Information

NPI: 1205165115
Provider Name: THREE RIVERS HEALTH NUTRITIONAL SERVICES
Classification: Dietitian, Registered - 133V00000X
Entity Type: Organization

CLIA Number: 23D2197070

Address:
701 S HEALTH PKWY
THREE RIVERS, MI
ZIP 49093
Phone: (269) 278-1145
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THREE RIVERS HEALTH NUTRITIONAL SERVICES is a dietitian registered in Three Rivers, MI. 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. THREE RIVERS HEALTH NUTRITIONAL SERVICES NPI is 1205165115. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

701 S HEALTH PKWY
THREE RIVERS, MI
ZIP 49093-352
Phone: (269) 278-1145
Fax: (269) 273-9611

The provider's authorized official is William Russell .
The authorized official title is Ceo/president and has the following contact phone number (269) 273-9601.

The CLIA number assigned to this NPI record is 23D2197070 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/24/2009 and was last updated on 12/24/2009.


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, Registered750020MICHIGANYes

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
10N99470OTHERMICHIGANMEDICARE GROUP PIN

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: 5/5/2024

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