Midwest Nutrition, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MIDWEST NUTRITION, PLLC

Practice address

103 North Ave Ste 8
Council Bluffs, IA 51503-1613

Phone

(662) 322-9037

NPI assigned

Apr 1, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Whitney Black, MS, RD, LD, LMNT

Title

Owner

Phone

(662) 322-9037

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1124879788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8169 S 185TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681366451",
            "telephone_number": "662-322-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 NORTH AVE STE 8",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031613",
            "telephone_number": "662-322-9037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8169 S 185th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681366451",
            "country_code": "US",
            "telephone_number": "662-322-9037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST NUTRITION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-03-30",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-322-9037",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, RD, LD, LMNT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.