Balanced Bites Nutrition LLC

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

Legal business name

BALANCED BITES NUTRITION LLC

Practice address

408 S Eagle Rd Ste 205
Eagle, ID 83616-6079

Phone

(208) 954-0862

Fax

(208) 668-8871

NPI assigned

Oct 19, 2023

Organization subpart

No

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

Authorized official

Name

Tracy Bento, RD, CDCES, CSOWMNPI 1134284045

Title

Registered Dietitian

Phone

(208) 954-0862

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Bento, RD, CDCES, CSOWM

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Eagle, ID
  • NPI 1134284045

  ID, Nutrition, Obesity and Weight Management

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1114709573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S EAGLE RD STE 205",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166079",
            "telephone_number": "208-954-0862",
            "fax_number": "208-668-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S EAGLE RD STE 205",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166079",
            "telephone_number": "208-954-0862",
            "fax_number": "208-668-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED BITES NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-19",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "BENTO",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "208-954-0862",
        "authorized_official_credential": "RD, CDCES, CSOWM"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Babendure, PT
• Shaunna Bach, MS,LPC,NCC,
• Back 2 Work Clinics
• Andrew Dale Baird, DDS, PLLC
• Hailey N. Baisch, MD
• Balanced Minds LLC
• Julia Ryann Banfield
• Victoria Barber
• Greer Barker
• Connie Sue Barnum

• All providers in Eagle, ID
• Obesity and Weight Management Nutrition Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.