Organization Active NPI

Haiku Nutritional Empowerment LLC

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1124790811
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
HAIKU NUTRITIONAL EMPOWERMENT LLC
Practice address
15212 N 2ND St
Phoenix, AZ 85022-3610
Phone
(602) 935-8791
NPI assigned
Sep 30, 2021
Last updated
Apr 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Mrs. Kelly Renee Robers, RDN, CDCESNPI 1851799357
Title
Ceo
Phone
(602) 935-8791

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

15212 N 2ND St
Phoenix, AZ 85022-3610

Mailing address

15212 N 2ND St
Phoenix, AZ 85022-3610
Phone (602) 935-8791

Other practice location 1

2550 W Union Hills Dr Ste 350
Phoenix, AZ 85027-5187
Phone (602) 456-0146 ext. 60146

Other identifiers 1

IdentifierTypeStateIssuer
1851799357MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.haikunutrition.net 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, 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": "1632960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1124790811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15212 N 2ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850223610",
            "telephone_number": "602-935-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15212 N 2ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850223610",
            "telephone_number": "602-935-8791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 W Union Hills Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850275187",
            "country_code": "US",
            "telephone_number": "602-456-0146 x60146",
            "fax_number": "833-441-1808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HAIKU NUTRITIONAL EMPOWERMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-30",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "ROBERS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-935-8791",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDN, CDCES"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851799357",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.haikunutrition.net",
            "affiliation": "N",
            "endpointDescription": "practice information and scheduling",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15212 N 2nd St",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850223610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.