Envision Nutrition Inc.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD00262 Issued in GA

Legal business name

ENVISION NUTRITION INC.

Practice address

1922 Highway 74 N
Suite D
Tyrone, GA 30290-1660

Phone

(404) 797-0528

NPI assigned

Jun 22, 2010

Last updated

Jun 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Donna P Decaille, RDNPI 1437102530

Title

Executive Director

Phone

(404) 797-0528

Specialties & licenses 1

Addresses

Locations

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.

• Donna P Decaille, RD

  • Registered Dietitian
  • Tyrone, GA
  • NPI 1437102530
  Authorized official Same address or phone

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1093036253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 HIGHWAY 74 N",
            "address_2": "SUITE D",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302901660",
            "telephone_number": "404-797-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 HIGHWAY 74 N",
            "address_2": "SUITE D",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302901660",
            "telephone_number": "404-797-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION NUTRITION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "DECAILLE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "404-797-0528",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD00262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Tyrone, GA
• Providers in Tyrone, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.