Organization Active NPI

Mindfull Nutrition LLC

Doing business as Mindfull Nutrition

  • Registered Dietitian
  • Buda, TX
National Provider Identifier
1104578772
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
MINDFULL NUTRITION LLC
Doing business as
Mindfull Nutrition
Practice address
200 N Main St Unit C
Buda, TX 78610-3329
Phone
(512) 670-8422
NPI assigned
Jan 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Chelsea N Goebler, MS, RD, LDNPI 1245705821
Title
Founder
Phone
(512) 944-7323

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

200 N Main St Unit C
Buda, TX 78610-3329

Mailing address

PO Box 1351
Buda, TX 78610-1351

Other practice location 1

825 Main St Ste 140
Buda, TX 78610-3273
Phone (512) 670-8422

Other names 1

  • Mindfull Nutrition Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220602000658 TX Part B Supplier - Clinic/Group Practice 3173901204 Receives reassigned benefits from 2 practitioners
Practice locations: Buda, TX

National Provider Directory

National Provider Directory

Locations

210 W Loop St
Buda, TX 78610
Phone (512) 670-8422

200 N Main St
Unit C
Buda, TX 78610
Phone (512) 670-8422

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1104578772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1351",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786101351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST UNIT C",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786103329",
            "telephone_number": "512-670-8422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Main St Ste 140",
            "address_purpose": "LOCATION",
            "city": "Buda",
            "state": "TX",
            "postal_code": "786103273",
            "country_code": "US",
            "telephone_number": "512-670-8422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFULL NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "GOEBLER",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "512-944-7323",
        "authorized_official_credential": "MS, RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindfull Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buda, TX

Sources for this page

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