Active NPI
Nourish Nutrition & Diabetes LLC
- Registered Dietitian
- Edmond, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1559
- Legal business name
- NOURISH NUTRITION & DIABETES LLC
- Practice address
- 1601 S State St Ste 500
Edmond, OK 73013-3698 - Phone
- (405) 254-6453
- Fax
- (405) 562-8735
- NPI assigned
- Jan 29, 2014
- Last updated
- Oct 7, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Johnston, RD
- Title
- Owner and Dietitian
- Phone
- (405) 509-1294
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1559 | OK | Primary |
Addresses
Primary practice location
1601 S State St Ste 500
Edmond, OK 73013-3698
Mailing address
1601 S State St Ste 500
Edmond, OK 73013-3698
Phone (405) 254-6453
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | NONE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1601 S State St
Ste 500
Edmond, OK 73013
Phone (405) 241-5836
3030 N West Expy
Ste 200149
Oklahoma City, OK 73112
Practitioners & affiliated clinicians
Practitioners 3
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": "1390953600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759795200000",
"number": "1275956062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 S STATE ST STE 500",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133698",
"telephone_number": "405-254-6453",
"fax_number": "405-562-8735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 S STATE ST STE 500",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133698",
"telephone_number": "405-254-6453",
"fax_number": "405-562-8735"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOURISH NUTRITION & DIABETES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-29",
"last_updated": "2025-10-07",
"certification_date": "2025-10-07",
"status": "A",
"authorized_official_last_name": "JOHNSTON",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "OWNER AND DIETITIAN",
"authorized_official_telephone_number": "405-509-1294",
"authorized_official_credential": "RD"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1559",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "NONE",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.