NPIMap

Organization Active NPI

Body to Soul, LLC

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1003671058
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
BODY TO SOUL, LLC
Practice address
119 S Western Ave Ste 213
Chicago, IL 60612-4643
Phone
(888) 383-5616
NPI assigned
Feb 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Jennifer BianchiniNPI 1770981516
Title
Owner
Phone
(631) 704-0751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

119 S Western Ave Ste 213
Chicago, IL 60612-4643

Mailing address

23 Penelope LN
Huntington, NY 11743-5910
Phone (631) 704-0751

Other practice location 1

23 Penelope Ln
Huntington, NY 11743-5910
Phone (631) 704-0751

Other practice location 2

1050 Brickell Ave
Miami, FL 33131-3945
Phone (631) 704-0751

Other practice location 3

1300 Brickell Bay Dr
Miami, FL 33131-3380
Phone (631) 704-0751

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1003671058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PENELOPE LN",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117435910",
            "telephone_number": "631-704-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S WESTERN AVE STE 213",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124643",
            "telephone_number": "888-383-5616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Penelope Ln",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "NY",
            "postal_code": "117435910",
            "country_code": "US",
            "telephone_number": "631-704-0751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Brickell Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331313945",
            "country_code": "US",
            "telephone_number": "631-704-0751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Brickell Bay Dr",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331313380",
            "country_code": "US",
            "telephone_number": "631-704-0751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BODY TO SOUL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "BIANCHINI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-704-0751"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.