Nourish by Lacey, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI1016 Issued in ME

Legal business name

NOURISH BY LACEY, LLC

Practice address

4 Market Place Dr
Suite 203, Box 15
York, ME 03909-1698

Phone

(207) 331-2381

NPI assigned

Nov 9, 2016

Last updated

Nov 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lacey M Bouchard, RDNPI 1871809632

Title

Registered Dietitian/Owner

Phone

(207) 331-2381

Specialties & licenses 1

Addresses

Locations

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.

• Lacey M Bouchard, RDN

  • Registered Dietitian
  • York, ME
  • NPI 1871809632
  Authorized official Same address or phone

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1144762071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MARKET PLACE DR",
            "address_2": "SUITE 203, BOX 15",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091698",
            "telephone_number": "207-331-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MARKET PLACE DR",
            "address_2": "SUITE 203, BOX 15",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091698",
            "telephone_number": "207-331-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISH BY LACEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "BOUCHARD",
        "authorized_official_first_name": "LACEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN/OWNER",
        "authorized_official_telephone_number": "207-331-2381",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI1016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in York, ME
• Providers in York, ME by specialty
• Registered Dietitian in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.