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NUTRISOURCE NUTRITIONAL SERVICES INC. NPI 1932486966


NPI Information

NPI: 1932486966
Provider Name: NUTRISOURCE NUTRITIONAL SERVICES, INC.

Former Legal Business Name: NUTRISOURCE, INC.

Classification: Dietitian, Registered - 133V00000X
Entity Type: Organization
Address:
504 BEACHVIEW DR
SUITE 2A
SAINT SIMONS ISLAND, GA
ZIP 31522
Phone: (912) 222-7755
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NUTRISOURCE NUTRITIONAL SERVICES, INC. is a dietitian registered in Saint Simons Island, GA. 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. NUTRISOURCE NUTRITIONAL SERVICES, INC. NPI is 1932486966. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Nutrisource, Inc..

The provider's business location address is:

504 BEACHVIEW DR
SUITE 2A
SAINT SIMONS ISLAND, GA
ZIP 31522-740
Phone: (912) 222-7755
Fax: (912) 434-7018

The provider's authorized official is Lauren G. Bailey .
The authorized official title is Owner and has the following contact phone number (912) 222-7755.

The enumeration date for this NPI number is 11/4/2011 and was last updated on 11/4/2011.


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, RegisteredLD002579GEORGIAYes

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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