NPIMap

Organization Active NPI

Family Food Nutrition

  • Registered Dietitian
  • Bala Cynwyd, PA
National Provider Identifier
1255976718
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
FAMILY FOOD NUTRITION
Practice address
150 Monument Rd Ste 207
Bala Cynwyd, PA 19004-1725
Phone
(800) 203-8657
Fax
(800) 258-1426
NPI assigned
Nov 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Krista Yoder Latortue, MPH, RDNNPI 1750561684
Title
Executive Director
Phone
(800) 203-8657

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 DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

150 Monument Rd Ste 207
Bala Cynwyd, PA 19004-1725

Mailing address

150 Monument Rd Ste 207
Bala Cynwyd, PA 19004-1725
Phone (800) 203-8657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200603000188 PA Part B Supplier - Clinic/Group Practice 9739500505 Receives reassigned benefits from 11 practitioners
Practice locations: Bala Cynwyd, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1255976718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD STE 207",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041725",
            "telephone_number": "800-203-8657",
            "fax_number": "800-258-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD STE 207",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041725",
            "telephone_number": "800-203-8657",
            "fax_number": "800-258-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOD NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "YODER LATORTUE",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "800-203-8657",
        "authorized_official_credential": "MPH, RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.