Organization Active NPI

Nutrition Made Simple LLC

  • Registered Dietitian
  • Milford, CT
National Provider Identifier
1104537216
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NUTRITION MADE SIMPLE LLC
Practice address
53 River St
Milford, CT 06460-3346
Phone
(203) 770-0475
NPI assigned
Dec 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Rachel LeighNPI 1740757749
Title
RDN
Phone
(203) 770-0475

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 Primary

Addresses

Primary practice location

53 River St
Milford, CT 06460-3346

Mailing address

53 River St
Milford, CT 06460-3346

Other identifiers 1

IdentifierTypeStateIssuer
1451OtherCTRDN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL nutritionmadesimple.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240328002593 CT Part B Supplier - Clinic/Group Practice 3577900356 Receives reassigned benefits from 1 practitioner
Practice locations: Milford, CT

National Provider Directory

National Provider Directory

Locations

53 River St
Ste 10
Milford, CT 06460

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": "1670544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1104537216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 RIVER ST",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 RIVER ST",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603346",
            "telephone_number": "203-770-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION MADE SIMPLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-09",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "LEIGH",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "RDN",
        "authorized_official_telephone_number": "203-770-0475"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RDN LICENSE",
            "identifier": "1451",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nutritionmadesimple.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "53 River St",
            "city": "Milford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064603346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.