J&M Nutritional Consulting Services, LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

LD000433 Issued in GA

Legal business name

J&M NUTRITIONAL CONSULTING SERVICES, LLC

Practice address

4053 Jimmie Dyess Pkwy Ste B
Augusta, GA 30909-9472

Phone

(706) 267-7479

NPI assigned

Apr 5, 2013

Organization subpart

No

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

Authorized official

Name

Mary L. Sullivan, R.D, LDN

Title

President/Ceo

Phone

(706) 267-7479

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1134462328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 HILLTOP DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4053 JIMMIE DYESS PKWY STE B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309099472",
            "telephone_number": "706-267-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J&M NUTRITIONAL CONSULTING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-05",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "706-267-7479",
        "authorized_official_credential": "R.D, LDN"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "LD000433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Augusta, GA
• Providers in Augusta, GA by specialty
• Preferred Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; 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.