NPIMap

Organization Active NPI

Fruitful Nutrition, LLC

  • Registered Dietitian
  • Durham, NC
National Provider Identifier
1205379401
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L003347 Issued in NC
Legal business name
FRUITFUL NUTRITION, LLC
Practice address
211 Winterberry Ridge Dr
Durham, NC 27713-9442
Phone
(574) 276-0699
NPI assigned
Nov 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Authorized official

Name
Rachel BordognaNPI 1407187602
Title
Registered Dietitian
Phone
(574) 276-0699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X L003347 NC Primary

Addresses

Primary practice location

211 Winterberry Ridge Dr
Durham, NC 27713-9442

Mailing address

211 Winterberry Ridge Dr
Durham, NC 27713-9442

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1205379401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 WINTERBERRY RIDGE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 WINTERBERRY RIDGE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139442",
            "telephone_number": "574-276-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRUITFUL NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "BORDOGNA",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "574-276-0699"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L003347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

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