Active NPI
Revamped by Nutrition
- Registered Dietitian
- Boulder, CO
National Provider Identifier
1033042080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- REVAMPED BY NUTRITION
- Doing business as
- Vita Nutrition
- Practice address
- 1327 Weaver Dr
Boulder, CO 80302-9669 - Phone
- (304) 923-6665
- NPI assigned
- Jun 8, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Josh Sisk, RDN
- Title
- Registered Dietitian
- Phone
- (304) 923-6665
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
1327 Weaver Dr
Boulder, CO 80302-9669
Mailing address
1327 Weaver Dr
Boulder, CO 80302-9669
Other names 1
- Vita Nutrition
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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": "1780876800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780876800000",
"number": "1033042080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1327 WEAVER DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "803029669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1327 WEAVER DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "803029669",
"telephone_number": "304-923-6665"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REVAMPED BY NUTRITION",
"organizational_subpart": "NO",
"enumeration_date": "2026-06-08",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A",
"authorized_official_last_name": "SISK",
"authorized_official_first_name": "JOSH",
"authorized_official_title_or_position": "REGISTERED DIETITIAN",
"authorized_official_telephone_number": "304-923-6665",
"authorized_official_credential": "RDN"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Vita Nutrition",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.