North Star Nutrition Counseling , LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

NORTH STAR NUTRITION COUNSELING , LLC

Doing business as

North Star Nutrition Counseling

Practice address

101 W Kirkwood Ave Ste 213
Bloomington, IN 47404-6134

Phone

(123) 180-4458

NPI assigned

Jan 30, 2024

Organization subpart

No

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

Authorized official

Name

Stacey Matavuli, REGISTERED DIETITIANNPI 1144433764

Title

Owner

Phone

(812) 318-0445

Specialties & licenses 1

Addresses

Other names 1

• North Star Nutrition Counseling Doing business as

Locations

Practitioners 1

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

• Stacey Matavuli

  • Registered Dietitian
  • Bloomington, IN
  • NPI 1144433764

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1003678467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 N JINNI LYNN CT",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474041181",
            "telephone_number": "812-318-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W KIRKWOOD AVE STE 213",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474046134",
            "telephone_number": "123-180-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR NUTRITION COUNSELING , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "MATAVULI",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-318-0445",
        "authorized_official_credential": "REGISTERED DIETITIAN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Star Nutrition Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chanelle Janette Norman, PT
• Cory Lee Norman, MD
• Lillian Grace Norris
• Sarah Elizabeth Norris, DO
• Suzette Danielle Norris
• Angela M Northcutt, PA-C
• David R Northcutt, D.P.M.
• Northern Indiana Emergency Physicians, LLP
• Northwest Hospitalist Physicians, LLP
• Rachael D Norton, MS, OTR, LDRS

• Registered Dietitian in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.