NPIMap

Organization Active NPI

Fuel2Live Nutrition, LLC

  • Preferred Provider Organization
  • Dorchester, MA
National Provider Identifier
1104560374
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
FUEL2LIVE NUTRITION, LLC
Practice address
48 Sudan St Apt 3
Dorchester, MA 02125-2079
Phone
(617) 308-0107
NPI assigned
Apr 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Michelle Marie Caslin, RD
Title
Owner/Registered Dietitian
Phone
(617) 308-0107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X Primary

Addresses

Primary practice location

48 Sudan St Apt 3
Dorchester, MA 02125-2079

Mailing address

48 Sudan St Apt 3
Dorchester, MA 02125-2079
Phone (617) 308-0107

Other identifiers 1

IdentifierTypeStateIssuer
1003396417MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Dorchester Direct

National Provider Directory

National Provider Directory

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": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1104560374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 SUDAN ST APT 3",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252079",
            "telephone_number": "617-308-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 SUDAN ST APT 3",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252079",
            "telephone_number": "617-308-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUEL2LIVE NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "CASLIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "617-308-0107",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003396417",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dorchester",
            "affiliation": "N",
            "endpointDescription": "Home office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "48 Sudan St Apt 3",
            "city": "Dorchester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021252079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.