Wise Nutrition LLC

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

ND5781 Issued in FL

Legal business name

WISE NUTRITION LLC

Practice address

35 Cambridge Trce
Ormond Beach, FL 32174-2471

Phone

(386) 675-0790

Fax

(888) 785-7846

NPI assigned

Feb 18, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy M Wise, MS/RD/LD/N

Title

Sole Proprietor

Phone

(386) 295-1265

Specialties & licenses 1

Addresses

Other names 1

• Nancy M Wise Former legal business name

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1255638797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CAMBRIDGE TRCE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321742471",
            "telephone_number": "386-675-0790",
            "fax_number": "888-785-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CAMBRIDGE TRCE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321742471",
            "telephone_number": "386-675-0790",
            "fax_number": "888-785-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "386-295-1265",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS/RD/LD/N"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "FL",
            "license": "ND5781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nancy M Wise",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Joseph Williamson
• Wanda Wilmore
• Jahilia Wilson
• Stella Lurene Wilson, PHARMD
• Barbara Ann Wipperfurth
• Wise Therapy Services LLC
• Michael Alan Wise, OTR
• Nancy M. Wise, M.S.,R.D.,L.D/N
• Elsa Marie Wittbold, DDS
• Women S Care OB GYN PA

• Renal Nutrition Registered Dietitian in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Renal Nutrition Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.