Active NPI
Samuel Huizenga Nutrition LLC
- Registered Dietitian
- Wayland, MI
National Provider Identifier
1063362069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samuel Huizenga, RD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 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 DirectoryPractitioners & 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.