The Fulfilled Fork, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

THE FULFILLED FORK, LLC

Practice address

1309 Coffeen Ave Ste 5655
Sheridan, WY 82801-5777

Phone

(307) 381-0662

NPI assigned

Aug 11, 2025

Organization subpart

No

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

Authorized official

Name

Haley Schroth, RDNNPI 1669253381

Title

Owner

Phone

(307) 381-0662

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.

• Haley Schroth, RDN, LD

  • Registered Dietitian
  • Sheridan, WY
  • NPI 1669253381

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1184509721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 COFFEEN AVE STE 5655",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 COFFEEN AVE STE 5655",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015777",
            "telephone_number": "307-381-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FULFILLED FORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "SCHROTH",
        "authorized_official_first_name": "HALEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-381-0662",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Jean Tellez, M.S.W.
• Stephen Scott Tenney, MD
• Dale Clifton Thames Jr., DMD
• Amie Ann Thayer, P.T.A.
• The Eric Group Behavioral Health LLC
• The Mind Gym LLC
• The Sheridan County Young Men's Christian Association
• The Spine of Wyoming Chiropractic
• Theo Wholesale LLC
• Thomas H Niethammer, MD, PC

• Registered Dietitian in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Registered Dietitian in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.