NPIMap

Organization Active NPI

Maui Nutrition Therapy LLC

Doing business as Maui Nutrition Therapy

  • Registered Dietitian
  • Kula, HI
National Provider Identifier
1063086064
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
MAUI NUTRITION THERAPY LLC
Doing business as
Maui Nutrition Therapy
Practice address
17732 Haleakala Hwy
Kula, HI 96790-8036
Phone
(808) 269-9633
Fax
(808) 862-6520
NPI assigned
May 14, 2021
Last updated
May 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Authorized official

Name
Andrea G De RoodeNPI 1396321840
Title
Owner
Phone
(808) 269-9633

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)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

17732 Haleakala Hwy
Kula, HI 96790-8036

Mailing address

PO Box 1147
Kula, HI 96790-1147
Phone (808) 269-9633

Other names 1

  • Maui Nutrition Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & 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": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1063086064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1147",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967901147",
            "telephone_number": "808-269-9633",
            "fax_number": "808-862-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17732 HALEAKALA HWY",
            "city": "KULA",
            "state": "HI",
            "postal_code": "967908036",
            "telephone_number": "808-269-9633",
            "fax_number": "808-862-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUI NUTRITION THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "DE ROODE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-269-9633"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maui Nutrition Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kula, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.