NPIMap

Organization Active NPI

Mindful Mama Nutrition

  • Clinic/Center
  • Lakeville, MN
National Provider Identifier
1013799626
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MINDFUL MAMA NUTRITION
Practice address
17900 Isle Ave
Lakeville, MN 55044-9652
Phone
(507) 200-2064
NPI assigned
Oct 18, 2023
Last updated
Oct 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Allison Reynolds, RDNPI 1265933089
Title
Owner, Registered Dietitian
Phone
(507) 200-2064

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
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

17900 Isle Ave
Lakeville, MN 55044-9652

Mailing address

17900 Isle Ave
Lakeville, MN 55044-9652

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1013799626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 ISLE AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 ISLE AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449652",
            "telephone_number": "507-200-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MAMA NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OWNER, REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "507-200-2064",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.