Organization Active NPI

Traveling Mama Enterprises, LLC

Doing business as Home Grown Nutrition

  • Registered Dietitian
  • Whitehall, MT
National Provider Identifier
1275177560
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
TRAVELING MAMA ENTERPRISES, LLC
Doing business as
Home Grown Nutrition
Practice address
67 S Lewis and Clark TRL
Whitehall, MT 59759-9547
Phone
(406) 209-3995
Fax
(406) 451-0551
NPI assigned
Oct 30, 2019
Last updated
Jul 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
Amy Horner, MPH, RD, CLC, RDNNPI 1225420151
Title
Owner
Phone
(406) 209-3995

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 NU Primary

Addresses

Primary practice location

67 S Lewis and Clark TRL
Whitehall, MT 59759-9547

Mailing address

67 S Lewis and Clark TRL
Whitehall, MT 59759-9547
Phone (406) 209-3995

Other names 1

  • Home Grown Nutrition Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200227002193 MT Part B Supplier - Clinic/Group Practice 3476980640 Receives reassigned benefits from 1 practitioner
Practice locations: Whitehall, MT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1275177560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 S LEWIS AND CLARK TRL",
            "city": "WHITEHALL",
            "state": "MT",
            "postal_code": "597599547",
            "telephone_number": "406-209-3995",
            "fax_number": "406-451-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 S LEWIS AND CLARK TRL",
            "city": "WHITEHALL",
            "state": "MT",
            "postal_code": "597599547",
            "telephone_number": "406-209-3995",
            "fax_number": "406-451-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVELING MAMA ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "HORNER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-209-3995",
        "authorized_official_credential": "MPH, RD, CLC, RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Grown Nutrition",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Home Grown Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whitehall, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.