NPIMap

Organization Active NPI

Southern Az Nutrition Consultants, LLC

  • Clinic/Center
  • Tucson, AZ
National Provider Identifier
1013472158
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SOUTHERN AZ NUTRITION CONSULTANTS, LLC
Practice address
1100 E Ajo Way Ste 212
Tucson, AZ 85713-5055
Phone
(520) 904-0889
NPI assigned
Feb 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Authorized official

Name
Javier Gomez, RDN, CDE
Title
Owner, Operator
Phone
(520) 904-0889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1100 E Ajo Way Ste 212
Tucson, AZ 85713-5055

Mailing address

11414 E Squash Blossom Loop
Tucson, AZ 85747-6219
Phone (520) 904-0889

National Provider Directory

National Provider Directory

Locations

8110 S Houghton Rd
Ste 158
Tucson, AZ 85747

NPI Registry JSON

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

{
    "created_epoch": "1549152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563753600000",
    "number": "1013472158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11414 E SQUASH BLOSSOM LOOP",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857476219",
            "telephone_number": "520-904-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E AJO WAY STE 212",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857135055",
            "telephone_number": "520-904-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN AZ NUTRITION CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-03",
        "last_updated": "2019-07-22",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "OWNER, OPERATOR",
        "authorized_official_telephone_number": "520-904-0889",
        "authorized_official_credential": "RDN, CDE"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.