Organization Active NPI

Samuel Huizenga Nutrition LLC

  • Registered Dietitian
  • Wayland, MI
National Provider Identifier
1063362069
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SAMUEL HUIZENGA NUTRITION LLC
Practice address
869 144TH Ave
Wayland, MI 49348-9733
Phone
(734) 929-8676
NPI assigned
Jan 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Authorized official

Name
Samuel Huizenga, RDNPI 1053277962
Title
Registered Dietitian
Phone
(734) 929-8676

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 DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

869 144TH Ave
Wayland, MI 49348-9733

Mailing address

609 Fulton St E Apt 1
Grand Rapids, MI 49503-4425

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.

NPI Registry JSON

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

{
    "created_epoch": "1769644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1063362069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 FULTON ST E APT 1",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 144TH AVE",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493489733",
            "telephone_number": "734-929-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL HUIZENGA NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A",
        "authorized_official_last_name": "HUIZENGA",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "734-929-8676",
        "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 Wayland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.

Verify at the official NPI Registry.