Organization Active NPI

Catalyst Nutrition and Training

  • Nutritionist
  • Kingston, PA
National Provider Identifier
1114643046
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Legal business name
CATALYST NUTRITION AND TRAINING
Practice address
480 Pierce St Ste 201
Kingston, PA 18704-5512
Phone
(888) 862-0803
Fax
(888) 862-0803
NPI assigned
Oct 12, 2022
Last updated
Nov 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Brooke Michelle Evans, RDNPI 1043852247
Title
Owner
Phone
(888) 862-0803

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU
Nutritionist 133N00000X NU Primary

Addresses

Primary practice location

480 Pierce St Ste 201
Kingston, PA 18704-5512

Mailing address

7 Aster Rd
Dallas, PA 18612-9759
Phone (570) 406-5375

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230316002845 PA Part B Supplier - Clinic/Group Practice 6901270768 Receives reassigned benefits from 2 practitioners
Practice locations: Kingston, PA

National Provider Directory

National Provider Directory

Locations

1272 Twin Stacks Dr
Dallas, PA 18612

480 Pierce St
Ste 201
Kingston, PA 18704
Phone (888) 862-0803

Practitioners & affiliated clinicians

Practitioners 2

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": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1114643046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ASTER RD",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186129759",
            "telephone_number": "570-406-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 PIERCE ST STE 201",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "888-862-0803",
            "fax_number": "888-862-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATALYST NUTRITION AND TRAINING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-862-0803",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.