Revive Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

REVIVE NUTRITION LLC

Practice address

3305 Washington St Unit 401
Jamaica Plain, MA 02130-5322

Phone

(314) 369-3159

NPI assigned

Jan 20, 2020

Organization subpart

No

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

Authorized official

Name

Kimberly A Sabada, RDNPI 1760813786

Title

Owner, Registered Dietitian

Phone

(314) 369-3159

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.

• Kimberly Ann Sabada, RD

  • Registered Dietitian
  • Jamaica Plain, MA
  • NPI 1760813786

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1093345969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 WASHINGTON ST UNIT 401",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021305322",
            "telephone_number": "314-369-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 WASHINGTON ST UNIT 401",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021305322",
            "telephone_number": "314-369-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-20",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "SABADA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER, REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "314-369-3159",
        "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": []
}

• Nina Elizabeth Reis
• Kristin Marie Reksc
• Meghan L Resetar
• Justin Resil Jr., DNP, MSN, APRN
• Lillian Reuman
• Sally Ann Reyering, M.D.
• David Reyes I
• Emily Reyes
• Rosa Reyes
• Shinji Rho, MD

• Registered Dietitian in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.