Summit Performance Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

SUMMIT PERFORMANCE NUTRITION LLC

Practice address

6156 Rockville Dr
Colorado Springs, CO 80923-3806

Phone

(719) 684-5754

NPI assigned

Jan 23, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jenna Moore-Liester, RD

Title

Owner

Phone

(719) 684-5754

Specialties & licenses 1

Addresses

Other names 1

• Summit Performance Nutrition Llc Doing business as

Practitioners 1

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

• Emily Grace Labombard, MPH, RDN, LDN

  • Registered Dietitian
  • Colorado Springs, CO
  • NPI 1063139764

  Dietitian, Registered

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1003370115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6156 ROCKVILLE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809233806",
            "telephone_number": "719-684-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6156 ROCKVILLE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809233806",
            "telephone_number": "719-684-5754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1060 Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Highlands Ranch",
            "state": "CO",
            "postal_code": "801292344",
            "country_code": "US",
            "telephone_number": "720-410-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT PERFORMANCE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "MOORE-LIESTER",
        "authorized_official_first_name": "JENNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-684-5754",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Performance Nutrition Llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Summit Hearing Aid Center
• Summit Home Health Care Inc
• Summit Integrated Health PLLC
• Summit Medical Clinic, PC
• Summit Nephrology PLLC
• Summit Physio & Performance, LLC
• Summit Primary Care
• Summit Primary Care
• Summit Primary Care
• Summit Psychiatry, LLC

• Registered Dietitian in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.