Nourishing Wellness Medical Center

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

NOURISHING WELLNESS MEDICAL CENTER

Practice address

819 N Harbor Dr Ste 310
Redondo Beach, CA 90277-2056

Phone

(310) 373-7830

Fax

(310) 373-7830

NPI assigned

Jun 15, 2006

Last updated

Apr 20, 2020By 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

Dr. Allen Hermann Peters, M.D.NPI 1881608909

Title

President/Medical Director

Phone

(310) 373-7830

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Nourishing Wellness Inc

  • Internal Medicine Physician
  • Redondo Beach, CA
  • NPI 1336321520

  O20061011000486

  Same enrollment

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.

• Allen Hermann Peters, M.D.

  • Public Health & General Preventive Medicine Physician
  • Redondo Beach, CA
  • NPI 1881608909
  Authorized official Same address or phone

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1164466884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N HARBOR DR STE 310",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772056",
            "telephone_number": "310-373-7830",
            "fax_number": "310-373-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N HARBOR DR STE 310",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772056",
            "telephone_number": "310-373-7830",
            "fax_number": "310-373-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISHING WELLNESS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "HERMANN",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-373-7830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David John Noonan, D.C.
• Nora Taylor, Psy.D., a Professional Psychology Corporation (Southbay Psychotherapy)
• David Eric Norman Sr.
• Matthew Connor Nottenkamper, OD
• Nourishing Wellness Inc
• Cynthia Michelle Nowicki, DO
• NRP Physical Therapy Corp. (Neuro Rehab Partners)
• Paulina Nunez
• Timothy John O'Connell, MD
• Victoria O'Driscoll

• Public Health & General Preventive Medicine Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Public Health & General Preventive Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.