Nutriphaserx LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

NUTRIPHASERX LLC

Practice address

100 Hartsfield Center Pkwy Ste 500
Atlanta, GA 30354-1377

Phone

(470) 812-1097

NPI assigned

Oct 4, 2021

Organization subpart

No

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

Authorized official

Name

Brenda Lemoine, RD,LDN

Title

Registered Dietitian/Owner

Phone

(470) 812-1097

Specialties & licenses 5

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1093487530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HARTSFIELD CENTER PKWY STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303541377",
            "telephone_number": "470-812-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HARTSFIELD CENTER PKWY STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303541377",
            "telephone_number": "470-812-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIPHASERX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-04",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "LEMOINE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN/OWNER",
        "authorized_official_telephone_number": "470-812-1097",
        "authorized_official_credential": "RD,LDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.nutriphaserx.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Referral Form",
            "address_1": "100 Hartsfield Center Pkwy Ste 500",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303541377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.