NPIMap

Organization Active NPI

Mind Belly Soul Nutrition LLC

  • Health Service Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1093432841
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
MIND BELLY SOUL NUTRITION LLC
Practice address
1807 Waterloo St
Philadelphia, PA 19122-2422
Phone
(678) 656-5830
NPI assigned
Oct 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Hannah Pfohl, MS, RD, LDNNPI 1730799222
Title
Registered Dietitian
Phone
(678) 656-5830

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
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1807 Waterloo St
Philadelphia, PA 19122-2422

Mailing address

1807 Waterloo St
Philadelphia, PA 19122-2422
Phone (678) 656-5830

Other identifiers 1

IdentifierTypeStateIssuer
1730799222OtherPANPPES

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.gethealthie.com/ Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

1221 Locust St
Philadelphia, PA 19107
Phone (202) 503-4373

Practitioners & affiliated clinicians

Practitioners 8

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": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1093432841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 WATERLOO ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191222422",
            "telephone_number": "678-656-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 WATERLOO ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191222422",
            "telephone_number": "678-656-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BELLY SOUL NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-23",
        "status": "A",
        "authorized_official_last_name": "PFOHL",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "678-656-5830",
        "authorized_official_credential": "MS, RD, LDN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1730799222",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.gethealthie.com/",
            "affiliation": "N",
            "endpointDescription": "Electronic medical record",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1807 Waterloo St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191222422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.