Option 1 Nutrition Solutions, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OPTION 1 NUTRITION SOLUTIONS, LLC

Doing business as

Aveanna Healthcare Medical Solutions - IL

Practice address

331 Salem Place
Suite 115
Fairview Heights, IL 62208-1340

Phone

(618) 467-1100

Fax

(844) 754-1345

NPI assigned

Jul 3, 2016

Organization subpart

No

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

Authorized official

Name

Matthew Buckhalter

Title

Cfo

Phone

(470) 464-8000

Specialties & licenses 1

Addresses

Other names 1

• Aveanna Healthcare Medical Solutions - IL Doing business as

Locations

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

{
    "created_epoch": "1467504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1134571060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE",
            "address_2": "SUITE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047",
            "telephone_number": "470-464-8000",
            "fax_number": "470-464-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SALEM PLACE",
            "address_2": "SUITE 115",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081340",
            "telephone_number": "618-467-1100",
            "fax_number": "844-754-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTION 1 NUTRITION SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-03",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare Medical Solutions - IL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.