Active NPI
Nourished on Time, LLC
- Registered Dietitian
- Waco, TX
National Provider Identifier
1053117382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- NOURISHED ON TIME, LLC
- Practice address
- 5500 Birdie Cir
Waco, TX 76708-5709 - Phone
- (254) 424-4758
- NPI assigned
- Feb 19, 2025
- 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
- Andrea Randolph, RD
- Title
- Dietitian
- Phone
- (254) 424-4758
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
5500 Birdie Cir
Waco, TX 76708-5709
Mailing address
5500 Birdie Cir
Waco, TX 76708-5709
Phone (254) 424-4758
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, 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": "1739923200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739923200000",
"number": "1053117382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 BIRDIE CIR",
"city": "WACO",
"state": "TX",
"postal_code": "767085709",
"telephone_number": "254-424-4758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 BIRDIE CIR",
"city": "WACO",
"state": "TX",
"postal_code": "767085709",
"telephone_number": "254-424-4758"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOURISHED ON TIME, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-19",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A",
"authorized_official_last_name": "RANDOLPH",
"authorized_official_first_name": "ANDREA",
"authorized_official_title_or_position": "DIETITIAN",
"authorized_official_telephone_number": "254-424-4758",
"authorized_official_credential": "RD"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.