NPIMap

Organization Active NPI

Nutrition Solutions

  • Registered Dietitian
  • Beaumont, TX
National Provider Identifier
1235583873
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT06620 Issued in TX
Legal business name
NUTRITION SOLUTIONS
Practice address
990 Interstate 10 N
Suite 215
Beaumont, TX 77702-1051
Phone
(409) 454-0417
Fax
(888) 977-1202
NPI assigned
Apr 20, 2016
Last updated
Apr 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
Mrs. Kellilyn Worley, MS, RDN, LDNPI 1760703045
Title
Owner
Phone
(409) 454-0417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT06620 TX Primary

Addresses

Primary practice location

990 Interstate 10 N
Suite 215
Beaumont, TX 77702-1051

Mailing address

990 Interstate 10 N
Suite 215
Beaumont, TX 77702-1051

Other identifiers 2

IdentifierTypeStateIssuer
3173858MedicaidTX
402025OtherTXMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

990 Interstate 10 N
Ste 215
Beaumont, TX 77702
Phone (409) 454-0417

Practitioners & affiliated clinicians

Practitioners 9

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": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1235583873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 INTERSTATE 10 N",
            "address_2": "SUITE 215",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021051",
            "fax_number": "888-977-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 INTERSTATE 10 N",
            "address_2": "SUITE 215",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021051",
            "telephone_number": "409-454-0417",
            "fax_number": "888-977-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "WORLEY",
        "authorized_official_first_name": "KELLILYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-454-0417",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT06620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3173858",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "402025",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.