Nutrition Core, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1312 Issued in OK

Legal business name

NUTRITION CORE, LLC

Practice address

1305 N Highway 66
Suite B
Catoosa, OK 74015-2460

Phone

(918) 557-0022

NPI assigned

Sep 30, 2010

Organization subpart

No

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

Authorized official

Name

Crystal Brook Bunney, MSHA, RD/LD

Title

Registered Dietitian

Phone

(918) 557-0022

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Crystal Brook Montgomery-Bunney, MSHA, RD/LD

  • Registered Dietitian
  • Claremore, OK
  • NPI 1285716803

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1265741748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15336 E 470 RD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740175372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N HIGHWAY 66",
            "address_2": "SUITE B",
            "city": "CATOOSA",
            "state": "OK",
            "postal_code": "740152460",
            "telephone_number": "918-557-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION CORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "BUNNEY",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "BROOK",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "918-557-0022",
        "authorized_official_credential": "MSHA, RD/LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285716803",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200049320B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Gabriela Mullins
• Shannon Cherie Nanaeto, MS, APRN-CNP
• Andrew Naylor, DMD
• Danielle Nees
• New Day Clinic of Catoosa, PLLC
• Daniel F O'Connor, DPT
• Emily Oberg
• Kimberly Jean Obermark
• Jacqueline Osborn
• John Parker

• Registered Dietitian in Catoosa, OK
• Providers in Catoosa, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.