NPIMap

Organization Active NPI

Ic Nutrition LLC

  • Registered Dietitian
  • Cayey, PR
National Provider Identifier
1013727353
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
IC NUTRITION LLC
Practice address
A3 Ave Miguel Melendez Munoz
Cayey, PR 00736
Phone
(787) 903-8020
NPI assigned
Jan 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
Ilca Jeannette Cruz Santiago, LNDNPI 1740736412
Title
Owner
Phone
(787) 616-9858

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

A3 Ave Miguel Melendez Munoz
Cayey, PR 00736

Mailing address

Urb Mirador Universitario
Calle 22 B13
Cayey, PR 00736
Phone (787) 616-9858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250402002832 PR Part B Supplier - Clinic/Group Practice 7911420633 Receives reassigned benefits from 1 practitioner
Practice locations: Cayey, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1013727353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB MIRADOR UNIVERSITARIO",
            "address_2": "CALLE 22 B13",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00736",
            "telephone_number": "787-616-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A3 AVE MIGUEL MELENDEZ MUNOZ",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00736",
            "telephone_number": "787-903-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IC NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "CRUZ SANTIAGO",
        "authorized_official_first_name": "ILCA",
        "authorized_official_middle_name": "JEANNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-616-9858",
        "authorized_official_credential": "LND"
    },
    "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 Cayey, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.