Lynnette R Blake, ND

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

701 NW Federal Highway
Suite 201
Stuart, FL 34994

Phone

(772) 600-5815

Fax

(772) 600-8012

NPI assigned

Jun 3, 2011

Last updated

Jun 3, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Back to Eden

  dba Back to Eden Wellness Center

  • Massage Therapist
  • Stuart, FL
  • NPI 1790085561
  Authorized official Same address or phone

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1215221544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 NW FEDERAL HIGHWAY",
            "address_2": "SUITE 201",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34994",
            "telephone_number": "772-600-5815",
            "fax_number": "772-600-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NW FEDERAL HIGHWAY",
            "address_2": "SUITE 201",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34994",
            "telephone_number": "772-600-5815",
            "fax_number": "772-600-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "LYNNETTE",
        "middle_name": "R",
        "credential": "ND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Robert Blackwell, D.O.
• Hugh Blackwood
• Navia Blackwood, RN, BSN
• Kacy Bladergroen, A.R.N.P.
• Gregory Michael Blake, PHARMD
• Christopher Blanchard
• Allison Katheryn Blanco
• Anais Blanco
• Maria Camila Blanco
• Nevaeh Blanding

• Nutritionist in Stuart, FL
• Providers in Stuart, FL by specialty
• Nutritionist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.