Philadelphia Nutrition and Wellness, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

PHILADELPHIA NUTRITION AND WELLNESS, LLC

Practice address

451 Hermitage St
Philadelphia, PA 19128-3301

Phone

(267) 314-7675

NPI assigned

Jul 15, 2021

Organization subpart

No

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

Authorized official

Name

Allison Leigh Shore, RDNPI 1942789268

Title

Owner/Dietitian

Phone

(267) 314-7675

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.

• Allison Leigh Shore

  • Registered Dietitian
  • Lafayette Hill, PA
  • NPI 1942789268
  Authorized official Same address or phone

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1225600430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HERMITAGE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283301",
            "telephone_number": "610-506-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HERMITAGE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283301",
            "telephone_number": "267-314-7675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2951 N 22nd St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191321505",
            "country_code": "US",
            "telephone_number": "267-800-7087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHILADELPHIA NUTRITION AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "SHORE",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER/DIETITIAN",
        "authorized_official_telephone_number": "267-314-7675",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.