Cranberry Blossom Nutrition & Wellness, LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

CRANBERRY BLOSSOM NUTRITION & WELLNESS, LLC

Practice address

236 Old Divide Rd
Roundup, MT 59072-6829

Phone

(907) 240-3267

NPI assigned

Apr 24, 2025

Last updated

Apr 24, 2025By 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

Elizabeth Thibodeau, DTR, ACE-CHCNPI 1386431013

Title

Owner

Phone

(907) 240-3267

Specialties & licenses 1

Addresses

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.

• Elizabeth Thibodeau, DTR, ACE-CHC

  • Registered Dietetic Technician
  • Roundup, MT
  • NPI 1386431013
  NPD Authorized official

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1184411746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 OLD DIVIDE RD",
            "city": "ROUNDUP",
            "state": "MT",
            "postal_code": "590726829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 OLD DIVIDE RD",
            "city": "ROUNDUP",
            "state": "MT",
            "postal_code": "590726829",
            "telephone_number": "907-240-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANBERRY BLOSSOM NUTRITION & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "THIBODEAU",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-240-3267",
        "authorized_official_credential": "DTR, ACE-CHC"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Area II Agency on Aging
• Bartow Welding, Inc.
• Brynn Marie Bixby, MPAC
• Pamela S Canon, ACUPUNCTURIST
• County of Musselshell (Musselshell County Ambulance)
• Dale a. Speiser, DC Inc (Roundup Chiropractic)
• Lorri L Denton, LCPC
• Matthew Joseph Eaton, DPT
• Tyler Chase Faw, PA-C
• Freeman Services Careerflex

• Community Health Clinic/Center in Roundup, MT
• Providers in Roundup, MT by specialty
• Community Health Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.