NPIMap

Organization Active NPI

Blossom Nutrition Services

  • Nutritionist
  • Naples, FL
National Provider Identifier
1134827900
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Legal business name
BLOSSOM NUTRITION SERVICES
Practice address
8251 Laurel Lakes Way
Naples, FL 34119-6793
Phone
(254) 458-6647
NPI assigned
Feb 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Rachel Tisdale, RD, LDNNPI 1003512179
Title
Manager
Phone
(254) 458-6647

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133N00000X Primary

Addresses

Primary practice location

8251 Laurel Lakes Way
Naples, FL 34119-6793

Mailing address

8251 Laurel Lakes Way
Naples, FL 34119-6793
Phone (254) 458-6647

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.

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1134827900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8251 LAUREL LAKES WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341196793",
            "telephone_number": "254-458-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8251 LAUREL LAKES WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341196793",
            "telephone_number": "254-458-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM NUTRITION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "TISDALE",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "254-458-6647",
        "authorized_official_credential": "RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.