Nutriwell LLC – Registered Dietitian

Key facts

NPI: 1003256181
Entity type: Organization (NPI type 2)
Primary specialty: Registered Dietitian 133V00000X
License: DN004001 (PA)
Legal business name: NUTRIWELL LLC
Practice address: 4055 Ridge Ave
3608
Philadelphia, PA 19129-1576
Phone: (267) 760-7778
NPI assigned: Jul 3, 2013
Organization subpart: No

Authorized official

Name: Angela M N, RD
Title: Owner
Phone: (267) 760-7770

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Angela M. Nolan, RD Registered Dietitian · Romansville, PA · NPI 1194979351

NPD DIETITIAN, REGISTERED

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Registered Dietitian Group: 193400000X SINGLE SPECIALTY GROUP	133V00000X	DN004001	PA	Yes

Addresses

Primary practice location

4055 Ridge Ave
3608
Philadelphia, PA 19129-1576

Mailing address

4055 Ridge Ave
3608
Philadelphia, PA 19129-1576
Phone (267) 760-7778

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 3, 2013.

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1003256181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 RIDGE AVE",
            "address_2": "3608",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291576",
            "telephone_number": "267-760-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 RIDGE AVE",
            "address_2": "3608",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291576",
            "telephone_number": "267-760-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIWELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "N",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-760-7770",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Registered Dietitian in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.