Individual provider Active NPI

Tamara Ann Grutza, NT, RD, LDN

  • Nutritionist
  • Plainfield, IL
National Provider Identifier
1023147808
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
164003339 Issued in IL
Practice address
22840 Eider CT
Plainfield, IL 60585-4506
Phone
(815) 207-1240
Fax
(630) 206-1656
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 164003339 IL Primary

Addresses

Primary practice location

22840 Eider CT
Plainfield, IL 60585-4506

Mailing address

22840 Eider CT
Plainfield, IL 60585-4506
Phone (815) 207-1240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
164003339ILMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Way to Grow Nutrition Therapy, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1023147808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22840 EIDER CT",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605854506",
            "telephone_number": "815-207-1240",
            "fax_number": "630-206-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22840 EIDER CT",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605854506",
            "telephone_number": "815-207-1240",
            "fax_number": "630-206-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUTZA",
        "first_name": "TAMARA",
        "middle_name": "ANN",
        "credential": "NT, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164003339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.