Midwest Performance Nutrition LLC

Primary specialty

Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X

Legal business name

MIDWEST PERFORMANCE NUTRITION LLC

Practice address

8060 Lexington PL Apt 10
Pleasant Prairie, WI 53158-2511

Phone

(309) 397-6406

NPI assigned

Aug 26, 2024

Organization subpart

No

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

Authorized official

Name

Abigail OlcottNPI 1184293706

Title

Registered Dietitian

Phone

(309) 397-6406

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.

• Abigail Jean Olcott, RD

  • Registered Dietitian
  • Kenosha, WI
  • NPI 1184293706
  NPD Authorized official

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1225861040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8060 LEXINGTON PL APT 10",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8060 LEXINGTON PL APT 10",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582511",
            "telephone_number": "309-397-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PERFORMANCE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "OLCOTT",
        "authorized_official_first_name": "ABIGAIL",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "309-397-6406"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myles D Maxwell, RN
• Cathy McClay, PT
• Douglas Marion McDaniel, PTA
• Shou Mei, MD
• Jordanna Metzger, RD, CD
• Rebekah Miller, RN
• Rade Milosevic, MD
• Dexter Molinaro
• Megan Molinaro, RBT
• Angelina M Montemurro, MD

• Sports Dietetics Nutrition Registered Dietitian in Pleasant Prairie, WI
• Providers in Pleasant Prairie, WI by specialty
• Sports Dietetics Nutrition Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.