NPIMap

Organization Active NPI

Nutrition Support Specialty Care

Doing business as Enteral

  • Registered Dietitian
  • Mount Pleasant, SC
National Provider Identifier
1053035899
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NUTRITION SUPPORT SPECIALTY CARE
Doing business as
Enteral
Practice address
1221 Hidden Lakes Dr
Mount Pleasant, SC 29464-9467
Phone
(843) 872-2090
Fax
(866) 421-3337
NPI assigned
Sep 26, 2022
Last updated
Jan 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Amy Berry, MS, RD, LDNPI 1346874641
Title
Owner
Phone
(434) 996-0507

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1221 Hidden Lakes Dr
Mount Pleasant, SC 29464-9467

Mailing address

1221 Hidden Lakes Dr
Mount Pleasant, SC 29464-9467
Phone (434) 996-0507

Other practice location 1

256 Sanctuary Lane
Palmyra, VA 22963
Phone (843) 872-2090

Other names 1

  • Enteral Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1053035899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 HIDDEN LAKES DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649467",
            "telephone_number": "434-996-0507",
            "fax_number": "866-421-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 HIDDEN LAKES DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649467",
            "telephone_number": "843-872-2090",
            "fax_number": "866-421-3337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "256 Sanctuary Lane",
            "address_purpose": "LOCATION",
            "city": "Palmyra",
            "state": "VA",
            "postal_code": "22963",
            "country_code": "US",
            "telephone_number": "843-872-2090",
            "fax_number": "866-421-3337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NUTRITION SUPPORT SPECIALTY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-996-0507",
        "authorized_official_credential": "MS, RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enteral",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Enteral",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.