Organization Active NPI

Pisgah Sports Nutrition LLC

  • Registered Dietitian
  • Asheville, NC
National Provider Identifier
1073342903
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
PISGAH SPORTS NUTRITION LLC
Practice address
2 Springside Park
Asheville, NC 28803-3325
Phone
(828) 290-9688
NPI assigned
Jul 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Authorized official

Name
Kendra MillerNPI 1548545049
Title
Owner
Phone
(907) 304-2500

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

2 Springside Park
Asheville, NC 28803-3325

Mailing address

2 Springside Park
Asheville, NC 28803-3325

Other practice location 1

20 Gala Dr # G-104
Asheville, NC 28803-8209
Phone (828) 290-9688

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": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1073342903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SPRINGSIDE PARK",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SPRINGSIDE PARK",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033325",
            "telephone_number": "828-290-9688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Gala Dr # G-104",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288038209",
            "country_code": "US",
            "telephone_number": "828-290-9688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PISGAH SPORTS NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-304-2500"
    },
    "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 Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.