Soulstice Nutrition LLC

Primary specialty

NutritionistTaxonomy code 133N00000X

Legal business name

SOULSTICE NUTRITION LLC

Practice address

553 Wyndale Rd
Abingdon, VA 24210

Phone

(423) 863-3072

NPI assigned

Feb 11, 2021

Organization subpart

No

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

Authorized official

Name

Amy Smith, CNS, LDN

Title

Owner

Phone

(423) 863-3072

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613001600000",
    "number": "1033701933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 WYNDALE RD",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "24210",
            "telephone_number": "423-863-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 WYNDALE RD",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "24210",
            "telephone_number": "423-863-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULSTICE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-863-3072",
        "authorized_official_credential": "CNS, LDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.soulsticenutrition.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "553 Wyndale Rd",
            "city": "Abingdon",
            "state": "VA",
            "country_code": "US",
            "postal_code": "24210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keri Nicole Smith, FNP-C
• Mark Samuel Smith, PA-C
• Robin Smith
• Sydni Kaylyn Smith, MSW
• Damian Sooklal, MD
• Southeastern Mobile Dental Services Inc
• Southwest Emdr Therapy LLC
• Southwest Virginia Physicians for Women
• Jacob Sowder, LPC
• Kristen Leigh Sparks, FNP

• Nutritionist in Abingdon, VA
• Providers in Abingdon, VA by specialty
• Nutritionist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.