Flag Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

FLAG NUTRITION, LLC

Practice address

718 W Grand Canyon Ave
Flagstaff, AZ 86001-5413

Phone

(928) 440-3374

NPI assigned

Aug 28, 2018

Organization subpart

No

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

Authorized official

Name

Lorraine Crim, RDN

Title

Owner, Nutritionist

Phone

(928) 440-3374

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1104307032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 W GRAND CANYON AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 W GRAND CANYON AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015413",
            "telephone_number": "928-440-3374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 N Beaver St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860014500",
            "country_code": "US",
            "telephone_number": "928-440-3374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLAG NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "CRIM",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "OWNER, NUTRITIONIST",
        "authorized_official_telephone_number": "928-440-3374",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.