Bright Sky Nutrition, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

2004029834 Issued in MO

Legal business name

BRIGHT SKY NUTRITION, LLC

Practice address

3543 S Lone Pine Ave
Springfield, MO 65804-4854

Phone

(417) 343-8222

Fax

(866) 542-3416

NPI assigned

Jun 9, 2016

Organization subpart

No

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

Authorized official

Name

Ladonna Marie Webb, RD, LD, CDE

Title

Owner/Dietitian

Phone

(417) 343-8222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunshine Weight Loss Club, LLC Former legal business name

Locations

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1124477104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3243 W KATELLA CT",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658078713",
            "telephone_number": "417-343-8222",
            "fax_number": "866-542-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3543 S LONE PINE AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044854",
            "telephone_number": "417-343-8222",
            "fax_number": "866-542-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SKY NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "LADONNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/DIETITIAN",
        "authorized_official_telephone_number": "417-343-8222",
        "authorized_official_credential": "RD, LD, CDE"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MO",
            "license": "2004029834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073807384",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunshine Weight Loss Club, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tanya L Brewer, CRNA
• Daniel J Bridges, LMSW
• Kelly Kathleen Bridges, PLPC
• Victoria Bridwell, DDS
• Alyse N Briggs, PHARMD
• James E Bright, MD
• Kristy Nicole Bright, OT
• Jeffrey Brinkman, A.T.C.
• Mary Katherine Brinkman, PA-C
• Linda L. Britt, LPC

• All providers in Springfield, MO
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.