Nutrition Balance LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

00595403 Issued in MI

Legal business name

NUTRITION BALANCE LLC

Practice address

22811 Greater Mack Ave
Suite 105
Saint Clair Shores, MI 48080-2021

Phone

(586) 778-4877

Fax

(586) 778-3004

NPI assigned

Mar 1, 2014

Organization subpart

No

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

Authorized official

Name

Susanne E Consiglio, RDNPI 1164453114

Title

Registered Dietitian

Phone

(586) 778-4877

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Susanne E Consiglio, RD

  • Registered Dietitian
  • Saint Clair Shores, MI
  • NPI 1164453114
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1393632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393632000000",
    "number": "1275958118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22811 GREATER MACK AVE",
            "address_2": "SUITE 105",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802021",
            "telephone_number": "586-778-4877",
            "fax_number": "586-778-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22811 GREATER MACK AVE",
            "address_2": "SUITE 105",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802021",
            "telephone_number": "586-778-4877",
            "fax_number": "586-778-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION BALANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-01",
        "last_updated": "2014-03-01",
        "status": "A",
        "authorized_official_last_name": "CONSIGLIO",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "586-778-4877",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "00595403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Novak, PH.D.
• Rudolph Sam Nucci, VETERINARIAN
• Charles Nudelman
• Kacee Nuppnau
• James Matthew Nuse, BCBA
• Nylah Alease Hair Collection LLC
• Rachel Eileen O'Byrne, MD
• Manuela B O'Campo, MD
• Alfonso V O'Neill, M.D.
• Hannah Occhietti

• Clinic/Center in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2014; 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.