Emerald Fare Nutrition Services, LLC.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

EMERALD FARE NUTRITION SERVICES, LLC.

Practice address

816 Glendale Ave
South Charleston, WV 25303-2519

Phone

(304) 395-5530

Fax

(681) 245-6369

NPI assigned

Jun 16, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Christine Laura Canterberry, MS, RD, CDECSNPI 1386345676

Title

Registered Dietitian

Phone

(304) 395-5530

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Practitioners 1

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

• Christine Laura Canterberry, MS, RD, LD.

  • Registered Dietitian
  • Charleston, WV
  • NPI 1386345676

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1275218356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 GLENDALE AVE",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253032519",
            "telephone_number": "304-395-5530",
            "fax_number": "681-245-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 GLENDALE AVE",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253032519",
            "telephone_number": "304-395-5530",
            "fax_number": "681-245-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD FARE NUTRITION SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "CANTERBERRY",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "LAURA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "304-395-5530",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, RD, CDECS"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Registered Dietitian in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.