NPIMap

Organization Active NPI

Courtney Darsa Nutrition LLC

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1023638392
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
COURTNEY DARSA NUTRITION LLC
Practice address
16 Madison SQ W FL 12
New York, NY 10010-1629
Phone
(516) 330-0944
Fax
(516) 407-5377
NPI assigned
Apr 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Courtney J Darsa
Title
Rd
Phone
(516) 330-0944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

16 Madison SQ W FL 12
New York, NY 10010-1629

Mailing address

16 Madison SQ W FL 12
New York, NY 10010-1629
Phone (516) 330-0944

Other practice location 1

515 Madison Ave
New York, NY 10022-5403
Phone (516) 330-0944

Other names 1

  • Nourishing NY Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL registereddietitian@gmail.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221104001612 NY Part B Supplier - Clinic/Group Practice 1759758691 Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

16 Madison Sq W
Fl 12
New York, NY 10010
Phone (516) 330-0944

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": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1023638392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MADISON SQ W FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101629",
            "telephone_number": "516-330-0944",
            "fax_number": "516-407-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MADISON SQ W FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101629",
            "telephone_number": "516-330-0944",
            "fax_number": "516-407-5377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100225403",
            "country_code": "US",
            "telephone_number": "516-330-0944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COURTNEY DARSA NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-09-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "DARSA",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "RD",
        "authorized_official_telephone_number": "516-330-0944"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "registereddietitian@gmail.com",
            "affiliation": "N",
            "address_1": "515 Madison Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100225403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nourishing NY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.