Organization Active NPI

Nutriwise LLC

  • Registered Dietitian
  • Cherry Hill, NJ
National Provider Identifier
1093144602
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ADA# 809015 Issued in NJ
Legal business name
NUTRIWISE LLC
Practice address
439 Burning Tree Rd
Cherry Hill, NJ 08034-3103
Phone
(856) 905-1525
Fax
(609) 482-8630
NPI assigned
Nov 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Mrs. Catherine Maria Harrison, RD, CDENPI 1982036323
Title
Owner, Nutriwise LLC
Phone
(856) 905-1525

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 ADA# 809015 NJ Primary

Addresses

Primary practice location

439 Burning Tree Rd
Cherry Hill, NJ 08034-3103

Mailing address

439 Burning Tree Rd
Cherry Hill, NJ 08034-3103
Phone (856) 905-1525

Other identifiers 1

IdentifierTypeStateIssuer
1982036323OtherNJINDIVIDUAL NPI

Other names 1

  • Nutrition Consulting Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131210000390 NJ Part B Supplier - Clinic/Group Practice 5092942466 Receives reassigned benefits from 1 practitioner
Practice locations: Cherry Hill, NJ

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": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1093144602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 BURNING TREE RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343103",
            "telephone_number": "856-905-1525",
            "fax_number": "609-482-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 BURNING TREE RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343103",
            "telephone_number": "856-905-1525",
            "fax_number": "609-482-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIWISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER, NUTRIWISE LLC",
        "authorized_official_telephone_number": "856-905-1525",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, CDE"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "ADA# 809015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1982036323",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nutrition Consulting",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.